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tervi 1880 Main Street • Centerville, MN 55038 <br /> Tstad(uhed 1857 CITY OF CENTERVILLE (612) 429 -3232 •fax (612) 429 -8629 <br /> APPLICATION FOR VARIANCE OR REZONING <br /> VARIANCE FEE ZZ&Z�•CUC) <br /> REZONING / DATE PAID 5 C ig <br /> STREET LOCATION OF `PROPERTY: l S <br /> L DESCRIPTION OF PROPERTY: <br /> - 31 - 2 - -1 - 0Cco - 5 / 27,3 mil - 2Z - 41 - Goc4{-) <br /> SIZE OF PARCEL (S) 20 ACME - <br /> PROPERTY OWNER: PHONE # 414,-+163 <br /> FEE OWNER: „at hhxk. I t e� r k �•G� <br /> ADDRESS: (O�IClS Q 717t —'' ✓i - . <br /> APPLICANT'S INTEREST IN PROPERTY: <br /> /FEE OWNER CONTRACT PURCHASER <br /> LEASE HOLDER OPTION TO PURCHASE <br /> DESCRIPTION OF REQUEST: e <br /> a . ,• - ea, N. - a k - ._i! t".S:Iseth <br /> 4 <br /> REASON FOR REQUEST: <br /> * Plus any additional costs <br /> Signature of applic. •° incurred for engineering, <br /> legal fees, publication or <br /> Signature of property owner other requirements. <br /> � - 2- 9:c4) <br /> Date <br />