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Ed fee: See attached notes regarding Fees and Instructions 1. Applicant information (a) Applicant name (b) Street address (c) Municipality (d) Phone number State/Zip code ( ) (e) Name and profession of person preparing plat (f) Street address (g) Municipality (h) Phone number State/Zip code ( ) 2. Property for which subdivision is requested (a) Location of property Street Block Lot Municipality (b) Property owner s name (c) Present mailing address (d) Phone number State/Zip ( ) (.

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