Variance application 7 19 26

TOWNSHIPOF WEST ORANGE APPLICATION FORM FOR THE PLANNING BOARD OR ZONINGBOARD OF ADJUSTMENT DDiCANT INFORMATION Full Legal Name: Gross man (Last) Max Mailing Address: 5 Ala (First) Street (Street) west 0range J 07052 Telephone Number: Ž) 252-2533 (City) (State) (Zip) _Email: maxrossSMan eoutlecIk, com Is the Applicant an: ndividual, Corporation, O Partnership, Other If the Applicant is a corporation or partnersthip, a list of interest or more in the names and the corporation addresses of persons or partnership must be attached. having a 10% Relationship ofthe applicant to the property: Owner, Tenant or Lessee,

g a 10% Relationship ofthe applicant to the property: Owner, Tenant or Lessee, Purchaser (with consent of owner, D Other (please specity) under contract Ifthe applicant is not the owner of the the owner(s) propcrty in question, the applicant authorization to procecd must submit an affidavit with this process. with B. PROPERTY OVNER INFORMATION Check here if same as applicant. If the owner is not the applicant, please complete the following: Owner's Name: Address: Telephone Number: ( Email: C.PROPERTY INFORMATION Street Address:5 Alan Block Number(s): |46 Street West OaaeM 07o52 ;Lot Number(s): 72 Tax Plate: 0066 The location of the property ; Zone of Property: R-T is approximately |00 feet from the intersection of Valiey

|00 feet from the intersection of Valiey andAlan Street (closest Has there been any previous intersection.) Zoning Board of Adjustment or Planning Board hearings involving this O Yes, Date(s): property? 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. Is this ANone property listed in "The Historic Sites Survey" by Robert Guter 7/9/1992 prepared O Yes No TAPLAMNING. DRDIDncument LlbrurylPU-ZDA Applleuitan 4-20-15.doe