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APPLICATION IS HEREBY MADE to the City of Lackawanna Planning and Development
Board for -a site plan review, special use permit, development plan review or subdivision review as
required by the Municipal Code of the City of Lackawanna. The applicant hereby agrees to comply with
& regulations.
atl applicable laws, rules, ordinances and
[{K\ enSoot Saleh
(Vl awsert SA, By
Name of Applicant
Address of Applicant Applicant Phone No,
eeeApplicant’s Email - | Role of Applicant to Project
(owner, attorney, lessee, deent,
architect, engineer, contractor...)
\ Property Owner: -
name: _{“lawsoeoe Sa te F
Address
Director of Development
\