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y <br /> Al ) <br /> CITY OF CENTERVILLE <br /> CONDITIONAL USE PERMIT REQUEST <br /> NAME: 3 .fit.? ie'A4 E E 'SC FEE: $250.00 + $500.00 <br /> Deposit <br /> COMPANY: ` J - 7 PAID: 7.Ce, ` Gc- ' z1 <br /> ADDRESS: / ` , / �� R 1 4 .' • L i_. w e h ) I ! L_ . , • / 0 <br /> TELEPHONE NUMBER: &.5 <br /> i5 -/ -? -- 4.-3) <br /> STREET LOCATION OF PROPERTY: ?I J7 ZO'r "hie- 4 011 <br /> PROPERTY IDENTIFICATION NUMBER: <br /> LEGAL DESCRIPTION OF PROPERTY: <br /> SIZE OF PARCEL(S): <br /> CONDITIONAL USE PERMIT REQUEST: / 0 <br /> r GCe e r CA 4S <br /> Ca f( w/l" c n Cj � ./w/L S <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 . - permit. I have also read the attached City Code, Section 156320 pertaining to Conditional Uses also. <br /> pay; : the above stated fee, I understand that no refunds will be issued in full or in part, at any item, even if the <br /> Signature of Applicant Signature of Property &er <br /> j,/2 f, <br /> D <br /> (Office Use Only Below This Line) <br /> PLANNING & ZONING ACTION: <br /> CITY COUNCIL ACTION: <br />