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<br />CITY OF CENTERVILLE
<br />
<br />APPLICATION FOR VARIANCE OR REZONING
<br />
<br />VARIANCE
<br />
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<br />
<br />*FEE
<br />
<br />REZONING
<br />
<br />DATE
<br />
<br />PAID
<br />
<br />STREET LOCATION OF PROPERTY:
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<br />LEGAL DESCRIPTION OF PROPERTY:
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<br />SIZE OF PARCEL(Sl
<br />PROPERTY OWNER :TllCfJif.\S
<br />
<br />"P'(""""I" '~-=;[),,"'ilk'PHONE II [,07_11;;'/'../<';:';';
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<br />FEE OWNER:
<br />ADDRESS:
<br />
<br />APPLICANT'S INTEREST IN PROPERTY:
<br />
<br />FEE OWNER
<br />
<br />CONTRACT PURCHASER
<br />
<br />LEASE HOLDER
<br />
<br />OPTION TO PURCHASE
<br />
<br />.l{ESCRIPTION OF REQUEST: \!O.'.','-'\ll<.-"t1T hUIld ,:'tVI (!(IAin/i'n "/'('
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<br />REhS.oN FOR REQUEST:' f...)E,,,-,Je{1 {]S U +:\,d,:-'~~l,lJ,'i' k,
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<br />Signature of applicant. .
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<br />
<br />* Plus any additional costs
<br />incurred for engineering,
<br />legal fees, publication
<br />or other requ'irements.
<br />
<br />Signature of prop~rty owner
<br />
<br />Date
<br />
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