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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 all applicable laws, rules, ordinances and regulations. Michael § EbAay Name of Applicant ignature of Applicant = , = = = oO, Oplper pplicant’s Email Role of Applicant to Project (owner, attorney, lessee, agent, architect, engineer, contractor...) Property Owner: NAMB: Michaz | Z EG)WA Address Director of Development