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Mes and addresses of all schools, churches, hospitals, public playgrounds, parks, and youth facilities located within 600 feet of your proposed premises. Measure all distances by direct line from the closest edge of the facility structure to the closest edge of your structure. Continue on reverse if needed. 1. APPLICANT NAME 2. PREMISES ADDRESS (Street number and name, city, zip code) 3. FACILITY NAME/ADDRESS DEPARTMENT USE ONLY LTR PERS DATE 1. DISTANCE SEPARATION FACTORS FT. NAME LTR.

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Keywords relevant to Form 251

  • pers
  • reliance
  • misinformation
  • omitted
  • playgrounds
  • omission
  • Applicant
  • misleading
  • constitute
  • Distances
  • Ft
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