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<br /> <br />e <br /> <br />. <br /> <br />SPECIAL ~S~ PER~11 <br /> <br />APP!.ICATIO\. F<l~ S?r,CI.\l. PE~"~: <br />!.toDER TIII- ;:O\.I~G OR~I'..\.'.CE <br /> <br />Fec: SlO~.OO <br /> <br />Case \0. <br /> <br />VIL!.AQ:. OF ROSE;\'H.!.E, \!I\',ESJ7\ <br /> <br />DIrectluns FIll out thIS fo~ .n ~~?ll'dte ~l tIP1ng or prInt1ng 1n In~. If the spaces <br />provIded are Insy!fl;le~t, ~se ad~lt.ona1 sheets, keYlnl Infor--at10n to the <br />prO?er 1tee nu~ber_ <br /> <br />BA4t e ON IN~ <br />S'me of ppl1cant: (Last) (FU'st) <br />Ad~lfof:PPh~'~ }( ~~j 3.~ St~~~(~~ <br />.s 11111 6- <br />-~aJ:le ot Owner: <br /> <br />1. <br /> <br />(\!tdole) <br /> <br />2. <br /> <br />(Cuy) <br /> <br />(State) <br /> <br />{Z1P): <br /> <br />3. <br /> <br />{laso- <br /> <br />(first) <br /> <br />(~lddle) <br /> <br />4. <br /> <br /> <br />lZIPr <br /> <br />(C lty) <br /> <br />(State) <br /> <br />s. <br /> <br />EUJ <br /> <br />6. <br /> <br /> <br />escnptlon 0 <br /> <br />7. Present Zon1ng D1strict : <br /> <br />8. <br /> <br />Zon1n~ Ord1nance SectIon Authorl:lng SpecIal Pernit: <br /> <br />Present Use Of Property: V,iCAA.I f + <br />fi '!I.rel'old r'1"'V,-,' J ;'i'e,S,<;jc..., f ,-.. Dc.~iDPlPtf~l(F <br />Proposed Use Of Property C:./A.v () -.J f{? A 7.,.{}.; ~l. r-c 'I' f, t:>"\J <br /> <br />DeSCrlpt10n of Request. rl.a '" tr:: ,;,., I /1/ .;. 1:3 /c7/~ tl.v S ,-fe.. <br />hntten statenent or. proposcJ uie of property (2 copIes) <br /> <br />Plan of proposed cevelojl~.ent (5 coples) E:,(.Ie./~.r.c;J. <br /> <br />9. <br /> <br />10 <br /> <br />11 <br /> <br />12 <br /> <br />Nhat WIll be the 0 ffeo;t of the ,J rO;Jo~(',l :..ISC O~ the Ile.1!:'" s~fety. and we J. fare of <br />occupants of surrO~nGln~ l~nds~ <br /> <br />;v" <br /> <br />j(!v(.~~-::: <br /> <br />.,; I ' .,t...- <br />.- or r (. <: i <br /> <br />13. hhat Jodi I)C tne effelwt .Ill c,u~tln7 and .mtld;J.t~J tr.lfflC "onJH~ons, lnl;.hhJl~g <br />par~lnR facI1I:1~S on .IJ1J.ccnt strects~ <br /> <br />,j~ ::.. ..vi'..=-.. ~L;{'-li~!~ .-!-:::::"~/(/f------_m <br />