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REZONING REQUEST CHECKLIST <br />OWNER'S NAME A=,c 4/N G' ADDRESS 350 <br />Current zonins Total number of acres S Current land use- <br />Type of rezoning requested z---t fIst Proposed land use <br />Tax map i 5 Block # •— Number of lots Proposed Water Supply: Public Community <br />Individual ✓ Proposed Sewage Treatment: Public Community Individual septic tank <br />Access onto state road i J Average daily traffic count on the state road iL5 escribe existing <br />critical areas: Flood prone areas Poorly drained areas N <br />Streams_ MIA Other sensitive areas AFIA <br />Describe lend uses in: General Area (�$► !� t <br />Kh.ye \vetW N ; <br />Adjacent parcels of land_CrsrorAt r JC amt Q,S It�fi4r�c gvq�+�Q ,_ <br />0 <br />f <br />