Application 6 12 25

TOWNSHIP OF WEST ORANGE APPLICATION FORM FOR THE PLANNING BOARD OR ZONING BOARD OF ADJUSTMENT Full Legal Name: West Orange Board of Education Mailing Address: 179 Essie Rock Avenue, West ordi i), NJO7052 (Street) (City) (State) (Zip) Telephone Number: 275 _) 669-5400 Email:_ hmoore@westorangeschools.org Is the Applicant an: O Individual, () Corporation, 0 Partnership, 0 Other ‘Non-profit corporation If the Applicant is a corporation or partnership, a list of the names and addresses of persons having a 10% i. interest or more in the corporation or partnership must be attached. NA Relationship of the applicant to the property: & Owner, () Tenant or Lessee, C] Purchaser under contract (with consent of owner, (1 Other (please specify) If the applicant is not the owner of the property in question, the applicant must submit an affidavit with the owner(s) authorization to proceed with this process, /B. PROPERTY OWNER INFORMATION B® Check here if same as applicant. If the owner is not the applicant, please complete the following: Owner’s Name: __ Address: _ Telephone Number: (___) Email: Cc “PROPERTY INFORMATION Street Address: 9 Manger Roa Oe; ) Block Number(s): 172 ; Lot Number(s): 29.01 ; Tax Plate: 3 Zone of Property: _&4 The location of the property is approximately feet from the intersection of. Ellison Avenue and__ Carlson Road (closest intersection.) Has there been any previous Zoning Board of Adjustment or Planning Board hearings involving this property? O Yes, Date(s): os tes 7 No If yes, please attach copies of the written decisions adopted by the Board to each application. Please attach a list of all contiguous or adjacent property owned by the applicant or owner.X] None Is this property listed in “The Historic Sites Survey” prepared by Robert Guter 7/9/1992 © Yes XI No TAPLANNING.DRINDucument Library\PB-ZRA Applteation 4-20-15. doe