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Fur Office Use Onl <br /> .9• 41.c1111.0,07,sir <br /> P°°0 <br /> 0'4P#l;cat;0 <br /> Distributed n Fee paid, Receipt <br /> uted t0 N0. <br /> Notification and nd Abutting <br /> (I5 calendar day proposed <br /> PropertyDate <br /> End of <br /> fA appeal per cr ac hmeQ Owners <br /> Appeal period native <br /> i�Council) <br /> DecisionDate <br /> Decision, ailed \ <br /> Encroachment <br /> D EncrOachnrertt Approved a Date <br /> ate <br /> Date Decision is Final Q �� <br /> .�• "eQ/s• (signature) <br /> Appellant Name <br /> Date <br /> $50,00 Appeal Fee ��, <br /> Paid. <br /> ��'crQn,. Receipt N0 <br /> Agreement <br /> phone. <br /> re <br /> ss <br /> Sent to Applicant fo Signature: <br /> e D <br /> ate; <br /> For Recording: <br /> Distributed T0 F,n <br /> ance, IIIIIITE Date: <br /> ngineerin=a Building, Operations Date: <br /> �_ Date <br /> Revised2/2g/2014 <br />