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tervi Cle 1880 Main Street • Centerville, MN 55038 <br /> Established 1857 CITY OF CENTERVILLE (612) 429 -3232 • Fat (612) 429 -8629 <br /> APPLICATION FOR VARIANCE OR REZONING <br /> VARIANCE FEE <br /> REZONING DATE PAID <br /> STREET LOCATION OF PROPERTY: 6 7 `J = ra;:e L • <br /> LEGAL DESCRIPTION OF PROPERTY: <br /> SIZE OFPARCEL(S) 7 _S ' 1 i00 <br /> PROPERTY OWNER: DAL' i 0 /< I t,10-1- I PHONE # E 5 >' 7 ? <br /> FEE OWNER: t J A - V it l ' L i ,4 I <br /> ADDRESS: ( 3o 6-al--- <br /> APPLICANT'S INTEREST IN PROPERTY: <br /> FEE OWNER CONTRACT PURCHASER _ <br /> LEASE HOLDER OPTION TO PURCHASE <br /> DESCRIPTION OF REQUEST: per, E /3 C: i t- 11 l ^ --r- <br /> pc 2c 1 -( <br /> REASON FOR REQUEST: <br /> RC& T'rt' u 67 <br /> * Plus any additional costs <br /> Signature of applicant incurred for engineering, <br /> legal fees, publication or <br /> Signature of property owner other requirements. <br /> Date <br />