|
SF� �'IrL USE PE:�ffT
<br />�,P�"�iCr�'TION r�R 3PECI�.L PF�
<br />.- JND�R. �-i E ZONI��iG ORDI NA�r'CE
<br />�
<br />�'�1LL�!GE 0�' RC�.SEVILLE, :2t3ivr.�flT�
<br />Direct�..ons : Fill out this f`orm in du�licaie by t,,%ping or
<br />printin� in ink. If' the spaces providea a.re insuificierit,
<br />use a�ditional sheets, keying ir�formation to the prooer
<br />item number.
<br />�.ch�x
<br />1, I�2me of :Applican
<br />�
<br />�
<br />�, �it�c�k•ess af Appli
<br />��; : �
<br />s,�._._ _.�� �+�y,
<br />��, ��.s . .t:_..i�.� �.L � 4l6'i��.rs
<br />: �O. &I]C� 31',P@��
<br />s'c
<br />st�
<br />s
<br />rs
<br />F�P: �5.0� ��� � �
<br />Case
<br />No.: �
<br />Rc�uting :
<br />I.D. Clerk
<br />Bldg. Insp.�
<br />Attornoy
<br />F,ngineer
<br />V. Admi.n.
<br />A.
<br />city and zone
<br />ta
<br />( contr�ct for c��ed b�Yer;
<br />���-�aa�e _
<br />�-~--� , .; I no and street city and zon� atate
<br />�� . �i�r�res� of �'.h�ner :
<br />�s�'� a� ��.��'
<br />,' . �" Street P�ddress of Prop�rty'inva ved: .
<br />..
<br />e�,��$y �1� p on of Proper�y Involved:
<br />� , �, .
<br />�, ;
<br />, r � ' Zonin� Ordinance Sectior�
<br />,., 7� ,P���enfi� �oning Distri�t: '
<br />, ., . { Authori zing Special Perrnit : �:
<br />a.� ; .��,� , �;�,+� ��.� ���.��.�� �.��i �3? .
<br />, _
<br />. , 10. �ropose� Use of' Property ,�; .
<br />�� : ,.9. .. Fr�s�nt Use oi P�operty:
<br />���e�t ��,.s� snd ���� �� ��"���.���
<br />r, ;. � r��lop ��ax k�au��g �i'�+��
<br />` J ;11. `SSescrip�iort af Request:
<br />$
<br />���l�t$� st,atement on prdposed use af property. (2 copies)
<br />,
<br />'� ; ;
<br />� Plat� of proposed developnient ( 5�opies) '
<br />��
<br />� 1 .5
<br />r.,,j` �,��,y�a,3.�: be �he efiect .qf.:the proposed use on �he h�al�h, safety, and we1,�aY'e of
<br />� t , 7,. s � � . , . ..
<br />�, ,, ' ; �; occupants oi surrounding 1anc�s� � : �y.1 .�y��{ �y,�j,y�+ 'jf�,f�j.+�/� �
<br />�3:. . �1 41.�V ����hr G �,L �+i�kl.i���.i� � SFb#.tii �'n' ^r S/ir11� , ..
<br />�,��,, `-�� � .� ����s�e�� � �.e �ec�.�t� �.e3.�a�.t�r
<br />� , ; ��.r� ��� �i�r�e ��'��� �k�� rie�.� ���� �nc� ��'�e �f t1�i+�
<br />"����� t e e z:e'ct�an existing and �nticipated traific conditions, includa.ng ,�� '
<br />a , ;� , a :' ws.
<br />` a��.n� iaciliiies on adjacPnt st�eets? Tia.� �x'e+� i� ��a�`�e�-y ��t���� w�.� �'� �e�►1��,c�� ,.
<br />,a � P �e� s�d �r�f'�3.� i� �:11�'� c��
<br />i
<br />' � ��" � �i��� �i�*��.4�3t�'� �Qt�"�t � 4�1�'� fi�'' '�t�t St1�b,��!a"� ���
<br />� < ��
<br />t T,,rl 1 be �he e' e�� on propert� values in the surraund�ng area� �e �e�c�� ��` '�he :
<br />} .:1 � . u�ta dtat�t� � ��C� ,
<br />;` ,��d: au� �g�v�. : �.�a � ��a�ar� . c��er�t�.z�n �ud th�: 1►ar�g tex�a r��u�;°� , �t�.t 'b� �o p'rc�
<br />.... . � tY�� u� �s� t�e
<br />� f�� ��e �r � a� �. , �+e��; :
<br />� �� ��� t�.
<br />1,' Acknow�edgment and Signa�ur�: The undersigned :isreb�r repr�asents upon a11. of th
<br />P
<br />enalties of l�w, for the purpose of' in�ucing the �Fz3.lage °e andet ateall work the
<br />acti.an herezn rec��ested, t�at all staiement�s h�re�.n are ru
<br />herein mentioned wwi.-ll be done in accordance �rith the ordinances of �� Village of ��
<br />. .. ::
<br />.. Rosevilles, and the laws of �ne �ta�e o� .•�.nneso a� /
<br />,. : a�u.r:e ���
<br />. gl� �,���.�-
<br />, _ ����-��
<br />ilsx i^.�
<br />
|