Buford. Lawrenceville ,500+ +/ /-2.89 CIC '16 0 ~ 4 AUG., ~ Planning & Development RZR

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1 Last Updated 2/20 14 CHANGE IN CONDITIONS APPLICATION APPLICANT INFORMATION OWNER INFORMATION* NAME: Mahaffey Pickens Tucker, LLP NAME: CMH Parks, Inc. ADDRESS: 1550 N Brown Road, Suite 125 ADDRESS: 5230 Belle Wood Ct, Ste A Lawrenceville Buford CITY: CITY: state: Georgia ZIP: state: Georgia ZIP: PHONE: PHONE: CONTACT PERSON: Shane Lanham or Jeff Mahaffey PHONE: CONTACT'S slanham@mptlawfirm.com or jmahaffey@mptlawfirm.com AN APPLICATION TO AMEND THE OFFICIAL ZONING MAP OF GWINNETT COUNTY, GEORGIA APPLICANT IS THE: [:8.] OWNER'S AGENT D PROPERTY OWNER D CONTRACT PURCHASER ZONING DISTRICTS(S): R-60 PRIOR ZONING CASE: RZR LAND DISTRICT(S): 6 LAND LOT(S): 68 ACREAGE: ADDREss of PROPERTY: McGee Road PRoPosED change IN conditions: Delete Condition 2(G) RESIDENTIAL DEVELOPMENT: NO. OF LOTS/DWELLING UNITS: +/-55 NON-RESIDENTIAL DEVELOPMENT: NO. OF BUILDINGS/LOTS: DWELLING UNIT SIZE (Sq. Ft.): 2,500+ TOTAL GROSS SQUARE FEET: GROSS DENSITY: +/-2.89 DENSITY: NET DENSITY: +/-2.89 PLEASE ATTACH A LETTER OF INTENT EXPLAINING WH CIC '16 0 ~ 4 2 AUG., ~ 2016 Planning & Development

2 LEGAL DESCRIPTION ALL THAT TRACT OR PARCEL OF LAND lying and being in Land Lot 68, 6th District, Gwinnett County, Georgia containing acres and being more particularly described as follows: FROM THE POINT OF BEGINNING leave the southerly right of way line of McGee Road and run South 04 degrees 49 minutes 29 seconds West feet to a metal blade found; thence run South 49 degrees 12 minutes 18 seconds East a distance of feet to a point; thence run South 60 degrees 3 0 minutes 3 7 seconds West a distance of feet to a point; thence run South 07 degrees 26 minutes 28 seconds West a distance of feet to a point; thence run North 62 degrees 07 minutes 39 seconds East a distance of feet to a point; thence run North 60 degrees 47 minutes 17 seconds East a distance of feet to a point; thence run South 00 degrees 46 minutes 45 seconds East a distance of feet to a 112 inch rebar found; thence run North 30 degrees 56 minutes 32 seconds West a distance of feet to a 1/2 inch rebar found; thence run North 34 degrees 41 minutes 25 seconds West a distance of feet to a 112 inch rebar found; thence run North 58 degrees 12 minutes 08 seconds East a distance of feet to a 1 inch steel bar; thence run North 29 degrees 18 minutes 21 seconds West a distance of feet to a 112 inch rebar found; thence run North 69 degrees 57 minutes 10 seconds East a distance of feet to a 1 inch open top pipe found; thence run North 59 degrees 39 rninutes 21 seconds East a distance of feet to a 1/2 inch rebar found; thence run North 29 degrees 22 minutes 12 seconds East a distance of feet to a 112 inch rebar found; thence run North 50 degrees 46 minutes 23 seconds West a distance of feet to a 112 inch rebar found; thence run North 39 degrees 26 minutes 25 seconds East a distance of feet to a 112 inch rebar found; thence run North 49 degrees 10 minutes 47 seconds West a distance of feet to a 1/2 inch rebar found; thence run North 04 degrees 45 minutes 49 seconds East a distance of feet to a 112 inch rebar found; thence run South 80 degrees 11 minutes 03 seconds East a distance of feet to a 1/2 inch rebar found and the POINT OF BEGINNING. CIC ' R CEIVED BY - AUG Planning & Development

3 !l.~7. w N1'1?1'".. ~ r, ~.. n w 11.(18 Nl' ' l " 41!.40 S J!'i'I Y f 10.0:' N l 1' " \II ~7.1!9 J., Sli4'!i5" Lltl(TioBl[ PBOI!PC-204 loneo:i.iur U t<( L(NCTH 8(AR!t!C 24.JO N4 i'' w!~~ ~,, :, ~: ::!~ : , , :10 C: 4Qi1',"..,. "..,,.. L12 Jtl.J.O 4'1i l'n" RCTAINlllCWAU. NOTE: A 'SO'ARA.U;eUIL.OINC PrfiUIT SHALL BE 08TAINE0 FOR AU. RETAINING W,.IJJ..S GREATER THA T 4 r!( T IN HEICHT AND AU. FlrTAIN!tlC WALLS US(!) AS A DAM PRIOR TO CONSfRUCnON Of nu: WAlLS. NOTE: CONSTRUCllON HOURS SHAll. BE Ulr.ll'rrn ~~~~~-~ ~~ - :o~oc~~~ ~OR~f:N~Y NOTE: lhe 2.5'_ FOOT IDIPORARY BUFFER REFERENct:O BY ZONING CONOillON NO. _v._ AND SHO"WN UPON nte APPUCABLE LOTS, SHALL RO.IAIN IN FORCE AND EFF'ECT ON EAOI INOI'V10UAL LOT UNnL THE APPROVAL OF ntefln.aj..plat.'" tl4 ' 7" J:l.ll! <; i'i'" F 1!>.7J 'Hli 'l " '"0'4Q'J!'\" ' "" L '" LJI!iO.I.'!!.l ":; tlil'l'l " f : S 4\ ' " ~: }~{{?C ~~~.oo <:: n ~ """" " w L J ~ '4 4" IOK.O!J 41 1'" " L"~ 116.2J 4 ~ 1 1 '!.6" r 7.Gl '1 4" 69.6:1 <::!,.,... 6~J<I ~-. - -~- - ~ w BUF'ftRNOTt: A.U.BUFTtRSANO m:;(savtar(astoej(q..(arl.y 10EI'-111nEO WITHPROTECn\ot: FEN CINGPRIOR TO CO!.I.I.t HC MCHT OF" AH'f LAND DI5TU R0 o\nc. OF'ENSPACENOTE.: 0PW 5PAC!: AR(A l0bt"0((0(0t0afl0 UAtNTAJ,.EO!!Y A OUAllntc HOW ~O\\l'l(RS ASSOCIATlON ;:e~~ ~~.,r:::ll( ~ ~~~~~ ~~~h~t~:r J~~~::~~z~~;;.. ~*T~il~~::::~c~ ::: :::R:::~.In L ~SUANcr rt A THISCOtl ctptp fu.sbitnrevicwcd»jo ~PPROVEO f OR Doi!RAL COI.IPUANCE WTH l)j[ lo.~i N C ~~~~i'r'~~t ~~~~"" Rt:cu"n''" or \ OV.'NER DUKE LAND GROUP, LlC 4828 ASHFORD DUNWOODY RO ~lin~~1~ ~~u3~~1 3 ~ROBST ( 770) <; 81LL!WUKE- LANO.CDt.l ENGINEER ACR ENGINEERING, INC. 600 PINNACLE COURT SUITE 685 NORCROSS, GEORGIA (678) ~ CON TACT: t\bbas HEIDARI A98ASIDACRENGINEERS.COM ~ ~:;:~:~~ f:~li~~h;~to::o:e:thor IZEO CAll ~~H~ll~~ ra ~U.C:'fic~R~~ ~~~~R~~~~R ~~:.i'i~i f 'g!,'i~~ ;:-..;,~~'!~.::::~.~\,y ~~~~~:~;;]~~,.,,":";[.~J~,~~~ ;;:~;;:ur,emergency CONTACT: ~~~6; 0 5r 1 ~~ Ptt~cn WILUAM PROBST I I (770) GRAPl llc SCALE.. ' L ~ CIC Plann\ng & Development.J

4 NOTES: I. BOUN DARY INFOR:\fAT10N TAKEN FRml Pl.i\T OF SURVEY FOR B.C. ROWNG, JR.. PREPARED BY D.J. GOBEL JR. DATED OCTOBER 21, 1067, PI.A.T BOOK P, PAGE 200. ~:,;~:~,;r~~~~~~~ltiatjon TAKEN FRO}! 3. WATER AND SANITARY SE'I'I'ER SERVICE PROVIDED DY GWINNETT COUNTY. 4. PROPERTY IS NOT LOCATED WITBIN THE FAR PART! 50 AIRPORT NOISE CONTOU R MAP. 5. THERE ARE STATE WATERS ON SITE ' TEJ.IPORARY DUFFER SHALL RE}WN rn ~~i.e UNTIL THE APPROVAL 01-' THE FINAL OWNER CMH PARKS, INC. D/8/A CHAF"IN BUILDERS ~~~T~ ~ELLE WOOD COURT 8UFORD, GA JOS1 8 ~~~~!~T~ 7 ~~R~~~-~gg~s E-M AIL:COR81TICHIGHGLENDS.COM ~ ACR ENGINEERING. INC. 600 PINNACLE COURT SUITE 68S NORCROSS, GEORGIA PHONE: (678) CONTACT: ABBAS HEIOARI E- MAIL: ABBAS!D'ACRENGINEERS.COM,.. _ 1000' PANEL 126 OF' 1 ~~ MAP NUMBER 1 ~1 ~!!IC01 2BF' MAP DATED: SEPTEMBER 2g. 200e NO PORTI ON OF TillS PROPERTY UES WITIIIN A Dt.:SJGNATED FLOOD PRONE AREA AS PER F.I.R.}I. CO.U.IUNITY PANEL 13135CO I2flf GWlNNETT COUNTY, GEORGIA EF'FECTIVE DATED SEPTEMBER 29, SITE SUMARY: TOTAL SITE AREA EXISTING ZONI NG PROPOSED ZONING WETLAND AREA FLOOD PLAIN AREA TOTAL OPEN SPACE TOTAL LOTS PROPOSED MAXIMUM DENSITY PROPOSED DENSITY MINIMUM LOT SIZE MINBIUll LOT W!DTR SETBACKS : FRONT YARD = 25 SIDE YARD = 5 FT (1 YARD), 15 FT (2 YARD) REAR YARD = 30 FT 7.4 A.C. R-100 R A.C A.C. 0.4 A.C. 24 LOTS 4 UNITS/AC UN!TS/AC. 7,200 S.F. 60 FT TRACTOESCRIPT10N ALLlH.ATTRACTORPARCELOfLANDL'riNCANDBEINCIN LAND LOT 68 Of THE 6 1h DISTRICT, Cl'o1NNETI COUNTY, C[ORCIA, AND BE!NC ~ORE P... RnCULARLY DESCRIBED AS FOLLOWS: C0t.1MENONC AT ~ REBAR found AT INT(RSECTION OF lhew[sterlyright- OF-WAYUNEOFOEL.MONlDRIY ( HAVING A ~0 FOOT 'HID( RICHT-Dr-WAY WIDTh) AND lh( SOUTHERLY RICHT - Of'- W,I,Y UN Of IAeC( ROAD ( H"VINC ~/Jf!!f~~ ~~irs~~ ~~N~TEr,~c~~~o~~N~~s~r:c~,s~~~~ 6: SAIOlRACTORPARCfLOrLANDCONTAIHS CRtS, INCLUOINCAU.EAS[..,[NTS. GRAPHIC SCALE ~. -w--' i CIC ' L!

5 Last Updated 2/20 14 CHANGE IN CONDITIONS APPLICANT'S RESPONSE STANDARDS GOVERNING THE EXERCISE OF THE ZONING POWER PURSUANT TO REQUIREMENTS OF THE UNIFIED DEVELOPMENT ORDINANCE, THE BOARD OF COMMISSIONERS FINDS THAT THE FOLLOWING STANDARDS ARE RELEVANT IN BALANCING THE INTEREST IN PROMOTING THE PUBLIC HEALTH, SAFETY, MORALITY OR GENERAL WELFARE AGAINST THE RIGHT TO THE UNRESTRICTED USE OF PROPERTY AND SHALL GOVERN THE EXERCISE OF THE ZONING POWER. PLEASE RESPOND TO THE FOLLOWING STANDARDS IN THE SPACE PROVIDED OR USE AN ATTACHMENT AS NECESSARY: (A) WHETHER A PROPOSED CHANGE IN CONDITIONS WILL PERMIT A USE THAT IS SUITABLE IN VIEW OF THE USE AND DEVELOPMENT OF ADJACENT AND NEARBY PROPERTY: Please see attached (B) (C) WHETHER A PROPOSED CHANGE IN CONDITIONS WILL ADVERSELY AFFECT THE EXISTING USE OR USABILITY OF ADJACENT OR NEARBY PROPERTY: Please see attached WHETHER THE PROPERTY TO BE AFFECTED BY A PROPOSED CHANGE IN CONDITIONS HAS REASONABLE ECONOMIC USE AS CURRENTLY ZONED: Please see attached (D) WHETHER THE PROPOSED CHANGE IN CONDITIONS WILL RESULT IN A USE WHICH WILL OR COULD CAUSE AN EXCESSIVE OR BURDENSOME USE OF EXISTING STREETS, TRANSPORTATION FACILITIES, UTILITIES, OR SCHOOLS: Please see attached (E) WHETHER THE PROPOSED CHANGE IN CONDITIONS IS IN CONFORMITY WITH THE POLICY AND INTENT OF THE LAND USE PLAN: Please see attached (F) WHETHER THERE ARE OTHER EXISTING OR CHANGING CONDITIONS AFFECTING THE USE AND DEVELOPMENT OF THE PROPERTY WHICH GIVE SUPPORTING GROUNDS FOR EITHER APPROVAL OR DISAPPROVAL OF THE PROPOSED CHANGE IN CONDITIONS: Please see attached CIC ' Ls 3 R CEIVED Y AUG Ianning & Developmen1

6 REZONING APPLICANT'S RESPONSE STANDARDS GOVERNING THE EXERCISE OF THE ZONING POWER (A) (B) (C) (D) (E) (F) Yes, the proposed development will permit a use that is suitable in view of the use and development of adjacent and nearby property. No, the proposed development will not adversely affect the existing use or usability of any of the nearby properties. Due to the size, location, layout and dimensions of the subject property, the Applicant subn1its that the property does not have reasonable economic use as currently zoned. No, the proposed development will not result in an excessive or burdensome use of the infrastructure systems. Yes, the proposed development is in conformity with the policy and intent of the Land Use Plan. Applicant submits that the recent successful rezoning applications of the subject property and adjacent property provide additional support of this Application. CIC ' R CE JVED BY AUG Planning & Development

7 Matthew P. Benson Gerald Davidson, Jr.* Brian T. Easley Kelly 0. Faber Christopher D. Holbrook Joshua P. Johnson LETTER OF INTENT FOR REZONING APPLICATION OF CMH PARKS, INC. dba CHAFIN BUILDERS Shane M. Lanham Austen T. Mabe Jeffrey R. Mahaffey Steven A. Pickens Andrew D. Stancil R. Lee Tucker, Jr. *Of Counsel Mahaffey Pickens Tucker, LLP submits this Letter of Intent and attached Change in Conditions Application (the "Application") on behalf of CMH Parks, Inc. d/b/a/ Chafin Builders (the "Applicant") for the purpose of modifying the conditions of zoning on an approximately acre tract (the "Subject Property") situated along McGee Road east of its intersection with Highpoint Road. The Subject Property is currently zoned R-60 pursuant to RZR Condition 2(G) ofrzr provides the following requirement: On any developed lot adjacent to the Schmidt property (PIN: R ), a sixfoot high chain link fence shall be provided, along with a staggered row of Thuga Green Giant trees which shall be 4-feet to 6-feet in height at the time of planting. Plantings 1nust be completed prior to the issuance of Certificates of Occupancy. Also, provide "No Trespassing" signs which shall be posted on the inside of the fence. The Applicant is in the process of acquiring the Schmidt property and plans to develop it together with the Subject Property as a single residential community. As shown on the site plan submitted with the Application, the Subject Property would connect to the Schmidt property via an extension of the existing Avenel Court. However, Condition 2(G) would require the Applicant to install a fence through the middle of several lots and across Avenel Court. Since Condition 2(G) is no longer necessary to protect the interests of adjacent property owners, the Applicant respectfully requests to delete Condition 2(G) in its entirety. R C 'VED BY Sugarloaf Office I I 1550 North Brown Road, Suite 125, La\vrenceville, Georgia CfC '16 Q 2 l~ NorthPoint Office II Cicero Drive, Suite 100, Alpharetta, Georgia AUG TELEPHONE FACSIMILE W\V\v.mptlawfirm.com lan ing & Oeve\opment

8 The Applicant and its representatives welcome the opportunity to meet with staff of the Gwinnett County Department of Planning & Development to answer any questions or to address any concerns relating to the matters set forth in this letter or in the Application filed herewith. The Applicant respectfully requests your approval of this Application. Respectfully submitted this 5th day of August, Y PICKENS TUCKER, LLP Attorneys for Applicant CIC ' Ianning & Development

9 Last Updated 2/20 14 CHANGE IN CONDITIONS APPLICANT'S CERTIFICATION THE UNDERSIGNED BELOW IS AUTHORIZED TO MAKE THIS APPLICATION. THE UNDERSIGNED IS AWARE THAT NO APPLICATION OR REAPPLICATION AFFECTING THE SAME LAND SHALL BE ACTED UPON WITHIN 12 MONTHS FROM THE DATE OF LAST ACTION BY THE BOARD OF COMMISSION ERS UNLESS WAIVED BY THE BOARD OF COMMISSIONERS. IN NO CASE SHALL AN APPLICATION OR REAPPLICATION BE ACTED UPON IN LESS THAN SIX (6) MONTHS FROM THE DATE OF LAST ACTION BY THE BOARD OF COMMISSIONERS. Date Shane Lanham, Attorney for the Applicant Type or Print Name and Title tary Public. nature of Notary Public CIC ' R CEIVED Y AUG Planning & Development

10 Last Updated 2/20 14 CHANGE IN CONDITIONS PROPERTY OWNER'S CERTIFICATION THE UNDERSIGNED BELOW, OR AS ATTACHED, IS THE OWNER OF THE PROPERTY CONSIDERED IN THIS APPLICATION. THE UNDERSIGNED IS AWARE THAT NO APPLICATION OR REAPPLICATION AFFECTING THE SAME LAND SHALL BE ACTED UPON WITHIN 12 MONTHS FROM THE DATE OF LAST ACTION BY THE BOARD OF COMMISSIONERS UNLESS WAIVED BY THE BOARD OF COMMISSIONERS. IN NO CASE SHALL AN APPLICATION OR REAPPLICATION BE ACTED UPON IN LESS THAN SIX (6) MONTHS FROM THE DATE OF LAST ACTION BY THE BOARD OF COMMISSIONERS. Date Jeff Mahaffey, Attorney for the Property Owner Type or Print Name and Title CI-G ' R CEIVED Y AUG Ianning & Oeve\opment

11 Last Updated 2/20 14 CONFLICT OF INTEREST CERTIFICATION FOR CHANGE IN CONDITIONS The undersigned below, making application for a change in conditions, has complied with the Official Code of Georgia Section A-I, et. seq, Conflict of Interest in Zoning Actions, and has submitted or attached the required information on the forms provided. Signature of Applicant Date Type of Print Name and Title.-...~ ure of Applicant's Attorney or Representative Date Shane Lanham, Attorney for the Applicant,,...,,,,,, ~ MCD"'i,,,-.''... 1ti'~ -~Y'.::l.o1AkJl. < ~ ~~.. y ~ : V.~1'11t~~ : : :. orgla! <C: Type or Print Name and Title DISCLOSURE OF CAMPAIGN CONTRIBUTIONS Have you, within the two years immediately preceding the filing of this application, made campaign contributions aggregating $ or more to a member of the Board of Commissioners or a member of the Gwinnett County Planning Commission? ~YES DNo Mahaffey Pickens Tucker, LLP If the answer is yes, please complete the following section: Your Name NAME AND OFFICAL CONTRIBUTIONS DATE CONTRIBUTION POSITION OF (List all which aggregate WAS MADE GOVERNMENT OFFICIAL to $250 or More) (Within last two years) Attach additional sheets if necessary to disclose or describe all contributions. CEIVE y CIC ' UG Planning & Development

12 CONFLICT OF INTEREST CERTIFICATION FOR REZONING/CHANGE IN CONDITIONS AND SPECIAL USE PERMIT APPLICATIONS MAHAFFEY PICKENS TUCKER, LLP NAME AND OFFICIAL POSITION OF GOVERNMENT OFFICIAL Tommy Hunter Jace Brooks John Heard Jace Brooks Tommy Hunter Charlotte Nash CONTRIBUTIONS $1000 $1000 $1000 $1000 $1000 $1000 DATE 03/05/ /05/ /31/ /29/ /27/ /08/2016 CIC ' Lt R CEIVED y J\UG Planning & Development Updated 04/29/2016

13 VERIFICATION OF CURRENT PAID PROPERTY TAXES FOR CHANGE IN CONDITIONS Last Updated 2/20 14 THE UNDERSIGNED CERTIFIES THAT ALL GWINNETT COUNTY PROPERTY TAXES BILLED TO DATE FOR THE PARCEL LISTED BELOW HAVE BEEN PAID IN FULL TO THE TAX COMMISSIONER OF GWINNETT COUNTY, GEORGIA. IN NO CASE SHALL AN APPLICATION OR REAPPLICATION FOR REZONING BE PROCESSED WITHOUT SUCH PROPERTY VERIFICATION. *NOTE: A SEPARATE VERIFICATION FORM MUST BE COMPLETED FOR EACH TAX PARCEL INCLUDED IN THE REZONING REQUEST. PARCEL I.D. NUMBER: District Land Lot Parcel Shane Lanham, Attorney for the Applicant Type or Print Name and Title Date TAX COMMISSIONERS USE ONLY (PAYMENT OF ALL PROPERTY TAXES BILLED TO DATE FOR THE ABOVE REFERENCED PARCEL HAVE BEEN VERIFIED AS PAID CURRENT AND CONFIRMED BY THE SIGNATURE BELOW) fl J$A- J( NAME TITLE 7 - ')._ 9- - ( & DATE R CEIVED Y ere '16 o ~ 4 All J Planning & Development

14 VERIFICATION OF CURRENT PAID PROPERTY TAXES FOR CHANGE IN CONDITIONS Last Updated 12/20 IS THE UNDERSIGNED CERTIFIES THAT ALL GWINNETT COUNTY PROPERTY TAXES BILLED TO DATE FOR THE PARCEL LISTED BELOW HAVE BEEN PAID IN FULL TO THE TAX COMMISSIONER OF GWINNETT COUNTY, GEORGIA. IN NO CASE SHALL AN APPLICATION OR REAPPLICATION FOR REZONING BE PROCESSED WITHOUT SUCH PROPERTY VERIFICATION. *NOTE: A SEPARATE VERIFICATION FORM MUST BE COMPLETED FOR EACH TAX PARCEL INCLUDED IN THE REZONING REQUEST. PARCEL I.D. NUMBER: (M P- District Land Lot Parcel of Applicant ane Lanham, Attorney for the Applicant Type or Print Name and Title Date ***PLEASE TAKE TH IS FORM TO THE TAX COMMISSIONERS OFFICE AT THE GWINNETT JUSTICE AND ADMINISTRATION CENTER, 75 LANGLEY DRIVE, FOR THEIR APPROVAL BELOW.*** TAX COMMISSIONERS USE ONLY (PAYMENT OF ALL PROPERTY TAXES BILLED TO DATE FOR THE ABOVE REFERENCED PARCEL HAVE BEEN VERIFIED AS PAID CURRENT AND CONFIRMED BY THE SIGNATURE BELOW) A H~t-4--- _1, 1) ~E_._ r NAM E TITLE S - L( ~ (c, DATE CIC '.16 0 ( R CEIVED Y UG PI n ing & Development

15 VERIFICATION OF CURRENT PAID PROPERTY TAXES FOR CHANGE IN CONDITIONS Last Updated 2/20 14 THE UNDERSIGNED CERTIFIES THAT ALL GWINNETT COUNTY PROPERTY TAXES BILLED TO DATE FOR THE PARCEL LISTED BELOW HAVE BEEN PAID IN FULL TO THE TAX COMMISSIONER OF GWINNETT COUNTY, GEORGIA. IN NO CASE SHALL AN APPLICATION OR REAPPLICATION FOR REZONING BE PROCESSED WITHOUT SUCH PROPERTY VERIFICATION. *NOTE: A SEPARATE VERIFICATION FORM MUST BE COMPLETED FOR EACH TAX PARCEL INCLUDED IN THE REZONING REQUEST. PARCEL I.D. NUMBER: (Map Reference Number) 6 District Land Lot Parcel of Applicant Shane Lanham, Attorney for the Applicant Type or Print Name and Title Date TAX COMMISSIONERS USE ONLY (PAYMENT OF ALL PROPERTY TAXES BILLED TO DATE FOR THE ABOVE REFERENCED PARCEL HAVE BEEN VERIFIED AS PAID CURRENT AND CONFIRMED BY HE IGNATURE BELOW) NAME ry-.ll\- -1 ~ DATE TITLE tlc '16 o \U G Ianning & Development

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