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CITY OF CENTERVILLE <br />CONDITIONAL USE PERMIT REQU T <br />NAME: �- ,► �r F E: $250.00+$500.00 <br />Deposit �t <br />COMPANY: 6A PAID:' <br />ADDRESS: q3 a � N <br />TELEPHONE NUMBER: 788.9aa5 <br />STREET LOCATION OF PROPERTY: a.uG� ted. MG;w Sl . <br />PROPERTY IDENTIFICATION NUMBER: 7cR 3 <br />LEGAL DESCRIPTION OF PROPERTY: d,(4- 3/- 9,d. - a3 - coo 1 <br />:7 p q,"� g- 164 - <br />SIZE <br />54 -SIZE OF PARCEL(S): 1, 7 5 <br />CONDITIONAL USE PERMIT REQUEST: �� ��- S�� od'4-ex-c tit -,W- <br />, <br />( 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 156.310 pertaining to Conditional Uses also. <br />By paying�tlY�ovc stated fee, I understand that no refunds will be issued in f1q or in part, at any item, even if the <br />o .t��erti f% <br />RECEIVED <br />Signature of Applicant Sign r f traerty Owner <br />CCD f) 6) 9n17 <br />Date <br />-------------------------------------------- <br />(Off,ce Use Only Below This Line) <br />PLANNING & ZONING ACTION: <br />CITY COUNCIL ACTION: <br />