MS-2012-00357_0004.tif Date Paid
Receipt #
A PPLICATI O N
FENCING I RIGHT OF WAY
FEE: $10.00 (Refundable if Easement Denied)
NAME OF APPLICANT: C� 2 z"2 f ' j
MAILING ADDRESS:
PHONE NUMBER:
LEGAL DESCRIPTION OF PROPERTY:
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STREET(S) BORDERING THE PROP TY:
HEIGHT OF FENCE: Residential: - -' commercial:
TYPE OF CONSTRUCTION: 1i C Z- Zoning:
X �z
Signaturof Applicant Signature of Applicant
Recommended Action by Administrator and Public Works Director: j
Approve Deny
If Denied, Reasons for Action:
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City Administrator Director of Public Works
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Action by Mayor:
Approve Deny
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Mayor
Action by City Council (if necessary):
Approve Deny
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