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ae SAyta pre asta ay sh ta ; evan ’ Weary,

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Eiviay py eh i) tae y bi ,
Say fas ish ’ ttt Servi

on  aiiee B f AN tt
Rit pater grt Ae Ae nth eee Ve :

SCHEDULE "A"
"Board of Variance Bylaw, 1981, No. 1919"

BOARD OF VARIANCE APPLICATION

NAME OF OWNER

NAME OF APPLICANT

(If Different From

MAILING ADDRESS

Postal Code

Phone No.

ADDRESS OF PROPERTY

(If Different From Above)

LEGAL DESCRIPTION

(Lot)

ZONING

CURRENT USE

DATE OF PURCHASE

Appeal):

Signature of Owner -

‘

Signature of Applicant
(1£ different from owner)