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PLA F -0007 (rev 08/24) <br />Owner: <br />(ID®®1fflr❑❑ID❑❑ OAAMOEMO❑ C <br />DBA: <br />Name: <br />[MOmigoCIfD❑®❑❑® ❑❑® Err <br />®®❑(ID5❑5C <br />Mailing Address:_ Om® <br />Telephone #:,-. ..❑�... ❑C _.._ <br />mEmail:.m M. mw®. ❑.❑® r� ❑l= <br />Property Parcel(s) Proposed for Agreement: <br />No. LCAD # Adress <br />Lot Block <br />Addition <br />1 • [10000 ❑❑❑C[D ❑Dd Cr ®❑ <br />DEM nigr <br />0 ❑❑❑® =0 EMM <br />_ . <br />2• 00000 ,,,,,,... 005®0.511 <br />® ®C <br />❑❑®dd®C <br />3.011000 DOODIM Eff] 00=0 <br />., ®®Dr[II <br />4. 00000 ❑®EOD ® ❑❑CSO <br />❑ <br />❑ U= Cry <br />5, <br />d additionaliptiInclude as an attachment a full legal description with metes <br />Ad...,_ - sheets if necessary. Full Legal Description: and <br />bounds or a copy of the deed, if available. <br />Improvements: <br />Type improvements for new Construction (check one): ❑ SF 0 2F ❑ MF <br />5 <br />Total Number of Dwelling Units: <br />Estimated Value of Improvements by type: „ ........... ..,....m... —.------ ....... <br />0000 <br />Estimated Start Date of Construction: . ...... —_ <br />Estimated Date of Completion of Project(s) .,,,®ll �❑� �.....� ...... �....�... <br />Description of Project (attach site plan, floor plan, etc.): ❑❑R ®❑❑❑mMD®CID ®®®m❑d (L'❑O'[ <br />�. � �r Date: ❑®®❑� <br />Applicant's Signature: �m..._ _ _. _ .. �R _. �. .._,- .- - <br />/ ` r' . ❑®®CQ5 <br />Owner's Signature: Date:..._. „�„e <br />Page 7 of 7 <br />