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<br /> <br />-7 ervi{{e <br /> <br />{i <br />188~ 'Main Street @ Centerviffe, 'M:T\[ 55038 \. <br /> <br />(651) 429-3232 @ 'fa?( (651) 429-8629 <br /> <br />NAME So i1.flCL <br />, <br />COlVll' ANY N I A <br />ADDRESS q )~!) I 1'E1;r 182 C t \2.- <br />TELEI:HONE NUlVffiER: rOe;! - W 2(0' to S30 <br />STREET LOCATION OF PROPERTY hDc-vvlr:: <br /> <br />CITY OF CENTERVILLE <br /> <br />SPECIAL USE PERMIT REQUEST-V. LL LJ . <br />bUCJOJff FEE\#~'77'J).06 t/L -,If>; 7;5.;1 <br />1 / <br />PAID: /)/Plo2- <br />, , <br /> <br />PROPERTY IDENTIFICATION NUMBER <br />LEGAL DESCRIPTION OF PROPERTY: '5el' <br /> <br />. . I) <br />aH.~,.,r-,"';"" . <br />_ t IU.... ~ . v , c '.~ ~ <br /> <br />SIZEOFPARCEL(S): 15+/- ()J'Jes <br />SPECIAL USE PERMIT REQUEST: ?JJlnY1{'c;L IJj/l~+ <br /> <br />Df U,q.IDvJrJ-'-i'k:f <br />, <br /> <br />PLANNING & ZONING ACTION: <br /> <br />CITY COUNCIL ACTION: <br /> <br />I have read the attached Ordinance #4, Division )t~: Special Use Pemiits Cpagf:. ~~ I was also presented with that <br />Section of Ordinance #4 that I may/may not be in compliance with and fully understand that if I am denied the <br />ramifications of same. <br /> <br />By paying the above stated fee, I .und~st~- that no refimds will be issued in full_or in part, at any item, even if the <br />outcome is denial <br /> <br />?}(i,JL/L CL ~Uc.lc:CJUc <br />Signature of Property Owner <br /> <br />Signature of Applicant <br />nIPJ/O;L <br />Date <br />