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Variance-Waiver Request Form
subd.doc 5 01/18/23 VARIANCE/WAIVER REQUEST FORM Date Plat Name File No._ Owner: Engineer:. Address: Address: Phone: Phone: Variance(s) Requested: (1} Justi Owner's PLANNING COMMISSION ACTION: BOARD OF DIRECTORS ACTION: Approval( ) Date Approval ( ) Date Denial ( ) Date Denial () Date Basis for Decision: Basis for Decision: