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CITY OF CENTERVILLE <br /> APPLICATION FOR VARIANCE OR REZONING <br /> A. VARIANCE ✓ FEE S•0. OO <br /> REZONING PAID <br /> • <br /> STREET LOCATION OF PROPERTY / 6 SS <br /> LEGAL DESCRIPTION OF PROPERTY SEC. 0 rev 3 / A sax <br /> Lc'r / IIi-If ( Cer- <br /> SIZE OF PARCEL (S) �° X /..C <br /> PROPERTY OWNER H''-»4n H° •r c e PHONE NO . /f 2.7 -?'YY/ <br /> (FEE OWNER) <br /> ADDRESS '7:7.-° .A-Djjrr , ✓)-'" /?A fTN, 5-x-.3 02 <br /> APPLICANT F- UC-- tRv 13 11 r 2- PHONE N0.40 <br /> ADDRESS 7 ( - > St CCrf- -rreLP c.cs hl>.. effr'rFevi1-"c.5 <br /> APPLICANT'S RELATIONSHIP 10 PROPERTY FEE OWNER <br /> . -., X CONTRACT PURCHASER <br /> _OPTION Ib PURCHASE LEASE HOLDER <br /> DESCRIPTION OF REQUESQS`t. -) •1oc .5 r. it sr'r QAC/T <br /> ISE gc e d t. i p fAe /t -3 ' ro 3) r <br /> 9 1CPfeert tor j)-Ofv;q FoJ rt...., Fijeticy Owli.:bc-ir� I <br /> E S PER/7 re »r a Twv Fa/7/<- y L , 0EcciNe- op 4.-57` <br /> REASON FOR REQUEST To 13 I c- U • A )'Y` X 'f' S/'G /r 5f- ra y <br /> Two FArrtc - y ff " -sr w1 rry 4- rTAern,: � YX30 <br /> G - /+-4A c <br /> IGNATU *E OF ' •PLI it T <br /> (SIGNATURE OF PROPERTY OWNER) <br /> I <br />