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CITY OF CENTERVILLE <br /> APPLICATION FOR VARIANCE OR REZONING <br /> VARIANCE V FEE v v <br /> REZONING PAID <br /> STREET LOCATION OF PROPERTY <br /> PDN-}. A3 -3/ 0 l <br /> LEGAL DESCRIPTION OF PROPERTY dam/" At - <br /> e,z )7 /0 /ciao? L--ei,d <br /> SIZE OF PARCEL (S <br /> PROPERTY OWNEflty.) 1,1 o-t -t25 PHONE NO. Zrei"-P7 51Q <br /> (FEE OWNER) <br /> ADDRESS <br /> t ,1 APPLICANT PHONE NO . <br /> 4' U ADDRESS <br /> 1 APPLICANT'S RELATIONSHIP TO PROPERTY ✓ FEE OWNER <br /> CON T$ACT PURCHASER .4 <br /> OPTION TO PURCHASE LEASE `HOLDER <br /> DESCRIPTION OF REQUEST <br /> REASON FOR REQUEST <br /> 31y,0,,n0.. / IG TUR^ OF APPLICANT <br /> I o bi. b (e) <br /> » �`" <br /> '" S`+ti a (SIGN.ATURE OF PROPERTY OWNER) <br /> (DATE) <br /> g - 1 3 - 8'� <br />