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CITY OF CENTERVILLE <br /> CONDITIONAL USE PERMIT REQUEST <br /> NAME: c ie��, C C E J e r.5 FEE: $250.00 + $500.00 <br /> i1 Q <br /> I l � Deposit <br /> COMPANY: 1 �U �"i C 1 S-Q, PAID: <br /> ADDRESS: ,C' t -\ \‘t4. , Mh '`MD <br /> TELEPHONE NUMBER: 011 H ci ( 4CI (p <br /> STREET LOCATION OF PROPERTY: "lO a.1 {- <br /> PROPERTY IDENTIFICATION NUMBER: a 1- 3I - r�c� (93 - 0013 <br /> LEGAL DESCRIPTION OF PROPERTY: Lk C k. I \ obi_ 1 rv1 t M-0— <br /> Pa (IL l-1 ;^ (`Q An t Ile_ <br /> SIZE OF PARCEL(S): o I a( (? S. <br /> CONDITIONAL USE PERMIT REQUEST: Ilia CS U5' �cl -r1. <br /> -Foy' a rl r3 clatj co. ra_ Vinci (.li� <br /> I have read the attached City Code, Section 156.030 pertaining to the B -1 Zoning District and the need to apply for a <br /> Conditional Use permit 1 have also read the attached City Code, Section 156.320 pertaining to Conditional Uses also. <br /> By paying the above stated fee, I understand that no refunds will be issued in full or in part, at any item, even if the <br /> otrtcccr� is denialp� I <br /> Signature of Applicant Signature of Property Owner <br /> (1/80/11 <br /> Date <br /> (o11.ic., use oal) Bclov6 This l.:nc; <br /> PLANNING & ZONING ACTION: <br /> CITY COUNCIL ACTION: <br />