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<br />,,,j}5d T-sta1J[ishea 1857 CITY OF CENTERVILLE (651) 429-3232 I\) !Ja;c (651) 429-8629
<br />APPLICATION FOR V ARlANCE OR REZONING
<br />
<br />1880 ']V[ainStreet .. Centervif[e; ']V[:A{ 55038
<br />
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<br />V ARlANCE: \/
<br />
<br />FEE: / ,"'5+
<br />
<br />Any additional costs incurred for
<br />engineering, legal fees, publication or
<br />other requirements
<br />
<br />REZONING:
<br />
<br />DATE PAID:
<br />I q 77 /kDbi'n ULt'e.,
<br />
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<br />STREET LOCATION OF PROPERTY:
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<br />SIZE OF PARCEL(S): "aaJ \O""'C\,
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<br />PROPERTY OWNER: ,Je:l1:l"rlA.(1--,~~'O;iutWJ:lj'6 PHONE #: uro:[- We..,;,- i! 1/
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<br />FEE OWNER: U~...-'-('<..)i~'y '1' S~..P\;1.a~".,;\~6<.'~~\€-~
<br />ADDRESS: V~77 ~~~""~ k~ :S<C'l~ ;C\2..y<,,~<L"'\1 ~ \\c . M~.:5KI ::<5'~'
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<br />APPLICANT'S INTEREST IN PROPERTY:
<br />
<br />,/
<br />1 FEE OWNER
<br />LEASE HOLDER
<br />
<br />CONTRACT PURCHASER
<br />OPTION TO PURCHASE
<br />
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<br />REASON.F,ORREQUEST: """,'r-.. o''\-~\,;>/;.. "" !.'- n'<';)"~";,,vO::<"(:o,,~c
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<br />
<br />I have read the attached Ordinance #4, Page 13 "Variance", Pages 55-62, Division 185: Variances,
<br />Section 185-010: Board of Appeals and Adjustments, Section 185-020: Variance Procedures, and
<br />Section 185-030: Variance Appeal Procedures, I was also presented with that Section of Ordinance #4
<br />that I may/may not be in compliance with and fully understand that if I am denied the ramifications of
<br />same.
<br />
<br />By paying the above stated fee, I understand that no refunds will be issued in full or in part, at any time,
<br />even if the outcome is denial.
<br />
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<br />Date
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