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1748 characters
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ON sice: (928) O66-0512
sboyleanickenbus yaz.org
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Town of Wickenburg
Community Development Application
Revised 06-24-2121
an : bap. AIS-LVEO =
Property Owner Applicant/Agent
Nine ty: Vike We, Snes hgen | : Name: [im Rasnake. Archicon A ihectire & Interiors. LC
Figs » A590 SS hey Lib ae | hd. Address: 5055 b Washington St, Sue 206
City. Sune. Zip bi key b 14 fy. FSZF9O _| Ciny. State. Zip: Phoenix. AZ 85034
‘Jelephone: 692-222-4266
Ad Canthay -Glopt|d G7] com
emai]: timr@archicon.com
Application Type
[7] Cse Permit | Remne/PAD Annexation Variance Text
CJ | O O O Amend
[] Preliminary | (] Final Plat Development (J Tech [Code
Plat Review Review Interpret
Request
Conveniences Store and Fueling Canopy for Terrible's
Parcel & Zoning Information
APIN» 20}-96-001G
Zoning District: PAD _| Flood Zone: X
Adjaceem Zoning:
Adjacent Land Use:
North: South: North: South:
hast: West: East: West:
Property Information
Site Dimensions: 41.463" X 467' Density: |
Site Are 250),392 sf (5.75 AC) Lot Dimensions
Site Arca Gross: Minimum: | Maximum:
Number of Units/Lots: Lot Area
Lot Coverage: 5.15% Minimum: | Maximum:
Utilities
Slcctric: [ Wickenburg | Gas: | | Water: | Private | Sewer: [Septic
For Staff Use Only
Mecting Date: Type of Application:
Vale Received: Application Number:
Sees:
Receipt Number/Date:
J hercby certify that the information submitted on this application is complete and accurate to the best of
my knowledge and that J am the owner and/or authorized agent as stated in this document.
Owner Signature MWe
Date: /2 7E-Z202.5
Applicant/Apent: wy
Complete application and return to Steve Boyle, sboyle@wickenburgaz.org along with fee.