HomeMy WebLinkAboutSUP Application Fee Refund 010721Revised 0712009
PERMIT REFUND FORM
DATE: 01 /07/21
I, Shahidah Nura Salaam representing Salaam Day Care Family Home
request arefund for SUP Application permit number
Type of Refund
issued to job address 1224 South Pulaski Street
for the amount of S 180.00
N/A
dated 12/07/20
My reason for requesting this refund is:
Applicant decided not to file application.
Signature
REFUND TO: Shahidah Nura Salaam
Address: 1224 South Pulaski Street
City, State, zip: Little Rock, Arkansas 72202
*FOR OFFICE USE ONLY# -
Project Address:
Permit Number: - I �02
tr
Ty e of Refund
Amount Charged:$ M.) Less Administrative Cost: $
Total Refund: $ I U V
From Account Numb :� g® SE)
Approved By: 1 w► �1 +� C ��
City of Little Rock
Planning and Development
Ring Fees
Date 2 120
Annexation $
Board of Adjustment $
Cond Use Permit/ T U P $
Final Plat $
Planned Unit Dev $
Preliminary Plat $
Special Use Permit S r7au
Rezoning $
Site Plans $
Street Name Change $
Street Name Signs
Number at ea $
Public Hearing Signs
Number—_aH�_ea $
j Total $ �'
File
Lac
API
By
Shahidah Nura Salaam
1224 S Pulaski St
Little Rock, AR 72202-4748
— 20�
1130
81-STM
Pay to the
Order of l y�
C Collars
Arvest Bank
L
For _ �T `� w
1:08 29008 7 21: 1130 00 5 794 266 iV
10
-----Original Message -----
From: Zay Love <snsalaam@gmail.com>
Sent: Wednesday, January 6, 20214:44 PM
To: Morris, LaSonya M. <Imorris@littlerock.gov>
Subject: Salaam Special Use Permit
CAUTION: This email originated from outside of the organization. Do not click links or open attachments
unless you recognize the sender and know the content is safe.
Good afternoon,
I am sending this email as notice that I would like to withdraw my application for special use permit
without prejudice for my home located at 1224 South Pulaski Street, Little Rock, 72202. 1 thank you for
your time and assistance with my application. Please let me know if anything further is needed.
Best Regards,
Shahidah Nura Salaam