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. � : Application Porm - Pags 2 <br /> , . ,�tarvr a�Ztl�rT�cTU�oc.. rfif�� <br /> . �OM /?A�-l�uvaT� Tp <br /> Period �y /��S t0 Style or Deeign G�,U;'�,�,/� <br /> �L l4�i0'� 'r ' <br /> VII . Please aubmit the Pollavring documeatatioa ( at�ach to <br /> back) : <br /> A. Map sho�ing the Zandmark( e) Iocation and prvperty <br /> liaea and/or ahoMing the districte( e) locatioa <br /> and atreet boundaries. <br /> B. PrePerabip black aad Mhite photographe {5" = 3 1/2" ) I <br /> and elides ahoMing vrheaever poeaible front , rear aad � <br /> side views oP propoaed laadmark( s) aad/or diatrict . <br /> C. Writtaa atatemeat oP si,gniPicance ( exp?aia in more <br /> detail Part VI . above) , <br /> D. Legal descrlDtion of prvDoeed laudmark( s ) aad�or <br /> district( s ) . <br /> B. Namn, telephons numbe�r and ma3liag addrees oP a2I. <br /> prvperty ownera ot the proposed landmark( e) or <br /> histcric district( a) . <br /> ----------------------------------------------------- <br /> POR OPPICIAL IISE ONLY <br /> Appl.icatioa ?evieMed By: <br /> . <br /> Yama of Kiataric Preserva�3on Admiaiatratar <br /> G�t� 5 �- �.G(!� <br /> Date: ..�Da� � ? � lQqO <br /> ��_ <br /> Yame oP Directar oP Communitq Developmeat <br /> �b�v(fl b. . c c.��� <br /> ,� <br /> �ppZication ia recommended £or: <br /> �ppro4a2 � j <br /> Approval xith modiPicaLiona [ ] <br /> Re,�action [ J <br /> i�� ���� C <br /> �.'�'"`— � <br /> Date DirecLor oP ` Commun3tq Developraent <br /> (ALtach D3rector oP Communitf Developmeat xrit�ea opinion} . <br /> _... . , <br /> --- --•-- ._. _ - -_.__ <br />