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• <br /> ` tervide 1880 Main Street • Centerville, na( 55038 <br /> L.1t hllisn 1. 1 CITY OF CENTERVILLE (651) 429.3232 • Fax (651) 429 -8629 <br /> APPLICATION FOR VARIANCE OR REZONING <br /> / / � Any additional costs incurred for <br /> VARIANCE: V FEE: /tics' + engineering, legal fees, publication or <br /> - other requirements <br /> REZONING: DATE PAID: /o -J2 -40 <br /> STREET LOCATION OF PROPERTY: - / /4L 719; <br /> LEGAL DESCRIPTION OF PROPERTY: ,e,Z3- 3 / -/.Z- /3 -46i3/ <br /> /-o r/Ll/✓. ,2 A.U! / 7.PAe.r / <br /> •E >��(nnrs zn/A AAA <br /> SIZE OF PARCEL(S): <br /> PROPERTY OWNER: Too-, Sc- v n PHONE #: 1- (D - 0.1; <br /> FEE OWNER: <br /> ADDRESS: kfl,a N\ 1;, , Aan) SSQ3 <br /> APPLICANT'S INTEREST IN PROPERTY: <br /> FEE OWNER CONTRACT PURCHASER <br /> LEASE HOLDER OPTION TO PURCHASEi p1kJ <br /> DESCRIPTION OF REQUEST: S n — &jhirdOu.Ijt(J- .CQd LiX(p Cad' <br /> "700 5 r _t-az —4x1.0 <br /> ►, w,ll r. / . Vvl.t. ^S3p, <br /> p tit <br /> It <br /> 1 in-L q.. r1 t6Mp " 5 2 <br /> REASON FOR REQUEST: <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 /> 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 outcomee is denial. <br /> Signature of Applicant Signature of Property Owner <br /> iD -�a -oo <br /> Date <br />