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<br /> <br />, <br /> <br />. , <br /> <br />.> <br /> <br />'" <br /> <br />Cl'1Y OF iD5EVIILE <br />2560 CIVIC CDll'EF. mr...'E <br />Pr&.VIrI.E, ~ 55113 <br /> <br />Please check ite:n or it.e::s fo:" ~-ich yal a...-e applyi."1;: <br /> <br />. j t <br />- rl Ki <br />~'OO (). it 11 <br />$~.'90 var;!).Int<'- <br /> <br />~ ~ Va-.~an:e; ~din; or non :ootcrizirl patl-~y <br />_ Klror Vanarc.e; Dn:vew-ay <br /> <br />Please cxcplete for:! b}. typing or pri...,tin; 1..."1 ink. If the SDacas provida::i are <br />ins'.lfficient, use aalitiorai sheets, keyi..-g i,'1fo::rnation to t.~ p..'"t..~ itsn runbP~: <br /> <br />1. <br /> <br />~ j\ . <br />{ , f11-i.../ ~ ~"'i <br />Name of Oomer: <br /> <br />/~ 1\ ~' ~-. - . <br />~ Ii., .' ;'".1- <br />(Mid::lle) <br /> <br />LL(.Q C" ^ "" -. ";;> <br />I~ 1~\.:J-.'./ <br />(!.a::.--t) , {B1a1e j <br /> <br />---'1 A/ .:;- ~J f"5 <br />(State) (Zip) <br /> <br />/.lg q, {'? 7 :5 <br />(~) '(R1one) <br /> <br />(~ <br />'. . <br /> <br />(First) <br /> <br />2. <br /> <br />"----" f\' ,:;:r <br />:> ?' -,' f-. ~', <br />(No. ~-n streetj <br /> <br />,: <br />~' SL ; L; L <br />~ v' ~... <br />- {City} <br /> <br />5 g L U,.-- <br />1tCrlress of Oomer: <br /> <br />CALv,'/li <br />C'~ of ~ica...rt): <br />L: of " <:.1 .-...' .;? .I <br />-J .15 ~ 1(;. ~ ,-, II ,; f t"- ./' V ~ <br />(iIOOress of AWl.): {No. a.m Street) <br />S'? L w 5 f! /{'/ f K /4 <br />~,-reet Address of Prope.....-ty Il'I\F.)lved: <br /> <br />3. <br /> <br />--- <br />~ <br />(First) <br /> <br />/ A ~~ <br />,- t'j r(' 'j' \ ' to' <br />(M;.dw.'~) '- - . <br /> <br />,ft x:: If, i, (. f .,4 /../ <br />(C~ty) (State) <br /> <br />r'-It~ <br />1-1 L., , J <br />(Zip) <br /> <br />4. <br /> <br />~, f;;. <br /> <br />5. <br /> <br />6. <br /> <br />""""""1 t.e T~-^"""l .' ~ - --" i"j <br />~'t" e ~ Des.....-:lI7..l.~ 0::: Pr;:pe.....t'J I!!\,Ol.'I,:c::u.: r ii, <br /> <br />..:-~-~~2-1.]- ).1--4- <br /> <br />7. Present Use of Pl.'C;pe-"t.y: t/ t? r , Ai;" S T' 'I ( ~ <br />8. Present z~ of Prope.......ty: J::l <br /> <br />Z;.o&./.~G <br />9. 'l~-ia..1'1Ce is ~..:.~u2d f==~ 'ti";c:. ::ollc'..~-.g ~--~~~(sJ u.i: t,.-,-a cit}4 v::02: i3. 0)"0 <br /> <br />19. Informtim 1oot-.ich DJSt he S1bnitted for all awlicatic:ns: <br /> <br />A. ~plicatic."1 a.""rl Fee <br /> <br />B. 8-1../2 X 11'1 Site PIa..., sh~,,;j:).] P~e..rt'i li.~1' ;.1.'"):: loc.at:~:1 of all ('.."CistLT"Kj <br />an.i p:-q.~ i:ip~'e::e..-:.s. <br /> <br />c. Writte.i a.F-;::~..~l f~":i ~r~~ or .1-d-;.10~Z1t cr ~h-::\" \.:~-rtic.5 affectC!d t~. <br />t11l~ varianc..~ req..:est. <br /> <br />D.. \\.T: ttcn St.J.t.t?-~i~ ::-L~ t::c ~ppl i.:.:L~~ e~:~~~. ,-1~~i.. ~ ~....t:y t::-2 .,;.=rr-~a..""k~ i 3 <br />r:-Cl-.c.....~<;3r/ .1~i "'~r..)t. ~~is.:......~~3. ,,-L...~ rr--C~~_~'""'it:. <br />