71-66cs!)
?he,, following lnformation..iS..to be typed ,or printed
D) NA~ O~ P~SEN~ ~R O~ PROPERTY ON ~ICH THIS ~Q~ST W~_,~
E) MAILING ADD.SS:
1~') TELEPHONE NO.:
# # I t t t # # t # t
THE APPLICANT IS NOT THE 'OWNER OF THE PROPERTY IN QUESTION,
Fii?LAIN: (Copy of pending contPact or option agreement shall
~ttaohed hePeto and made a parc of this application.)
3)
A)
LOCATION OF PROPERTY IN QUESTION
(Following information to be obtained t' the applicant
from the Office of the County Assessor)
MAGISTERIAL DISTRICT~,~~/ B) TAX MAP NO.
C) SEC. NO, ~_~___ D) SUBDIVISION NO. _ ..... E) BLOCK NO ......
P) ~:'~ OR PARCEL N0., :./,: , G) STREET
A PLAT OF 'f:'YIS PROPERTY SHALL BE A~ACHED HE.TO A~ ~DE A PART
OF THiS APPLICATION S~WING THE FOLLOWING:
LOCATION BY REFERENCE TO NEAREST ROAD INTERSECTION
DIMENSIONS OF SITE
(PAGE
THE PETITIONER REQUESTS THAT THE ZONING ORDINANCE BE AMENDED TO
5)
RECLASSIFY THIS PROPERTY FROM
' '1 NO./NAME
TO C-- 2L
"NO',/NAME'"
STATE THE REASON FOR THIS REQUEST:
/
6) STATE HOW THIS REQUEST WILL NOT BE MATERIALLY DETRIMENTAL TO
THE ADJACENT PROPERTY OWNERS OR THE SURROUNDING NEIGHBORHOOD:
7)
STATE ANY EXISTING USE PERMIT OR VARIANCE GRANTED PRE"~IOUSLY ON
THE PARCEL IN QUESTION:
~) EXISTINGLA}D USE:
(PAGE 2)
9) GIVE NAMES OF ALL OWNERS ADJACENT, ACROSS THE ROAD OR HIGHWAY
AND FACING THE PROPERTY AND ANY OWNERS ACROSS ANY RAILROAD RIGHT_
OF WAY FROM SUCH PROPERTY. IN THE EVENT THE PROPERTY aFFECTED
IS SITUATED AT OR WITHIN 100 FEET ON THE INTERSECTION OF ANY
TWO OR MORE ROADS OR ~IGHWAYS, AT OR WITHIN ONE HUNDRED FEET
OF THE INTERSECTION OF ANY ROAD OR HIGHWAY WITH A RAILROAD RIGHT-
OF-WAY OR AT OR WITHIN ONE HUNDRED FEET OF THE INTERSECTION OF
· THE RIGHTS-OF-WAY OF ANY TWO RAILROADS, GIVE NAMES OF PROPER~f
OWNERS AT ALL CORNERS OF ANY SUCH INTERSECTION.
s
MAILING ADDRESS: ~ .~ . ~'/~/~ ~,/~./~~~ .. ~_'
TAX MAP NO.: /~ SEC. NO.: /~ SUBDIVISION NO.: .
BLOCK NO.: LOT OR PARCEL NO.:
B)
TAX NAP NO.: /~_ SEC. NO.: /& SUBDIVISION NO.:
BLOCK NO.: LOT OR PARCEL NO.: ~ ~ /~ . _~
c)
MAILING ADDRESS: ~.~., /
TAX ~P NO.: . . SEC. NO.:
BLOCK NO.: L~ OR PARCEL NO.: .........
D) PROPERTY OWNER'S NAME:
MAILING ADDRESS:
TAX MAP NO.: SEC. NO.:
SUBDIVISION NO.:
BLOCK NO.: LOT OR PARCEL NO.:
(P~GE ~)
E) PROPERTY OWNER ' S NAME:
MAILING ADDRESS:
TAX MAP NO.:
SEC. NO.:
SUBDIVISION NO.:
BLOCK NO.:
LOT OR PARCEL NO.:
F) PROPERTY OWNER' S NAME:
MAILING ADDRESS:
TAX MAP NO.: SEC. NO.:
SUBDIVISION NO.:
BLOCK NO.:
LOT OR PARCEL NO.:
G) PROPERTY OWNER'S NAME:
MAILING ADDRESS:
TAX MAP NO.: SEC, NO,:
SUBDIVISION NO.:
BLOCK NO,:
LOT OR PARCEL NO.:
H) PROPERTY OWNER'S NAME:
MAILING ADDRESS:
TAX MAP NO.:
BLOCK NO.:
SEC. NO.: SUBDIVISION/NO.:
LOT OR PARCEL NO.:
I) PROPERTY OWNER'S NAME:
MAILING ADDRESS:
TAX MAP NO.: SEC. NO.:
SUBDIVISION NO.:
BLOCK NO,: ,LOT OR PARCEL NO.:
OWNER'S NAME:
MAILING ADDRESS'
TAX MP~P NO. - SEC. NO.: SUBDIVISION NO.:
BLOCK NO.: , LOT OR PARCEL NO.: ................
(PAGE
~o)
THE APPLICANT HEREWITH DEPOSITS THE SUM OF TWENTY DOLLARS
($20.00) ATTACHED TO THIS APPLICATION, TO PAY THE COST OF
ADVERTISING NOTICE OF THE HEARING OF SAID BOARD TO ACT ON
THIS REQUEST. CHECK OR MONEY ORDER MUST BE MADE PAYABLE
TO: TREASURER~ CO,U~..TY OF CHESTERFIELD.
I/WE HEREBY DEPOSE AND SAY THAT ALL OF THE ABOVE STATEMENTS
AND THE STATEMENTS CONTAINED IN ANY EXHIBITS TRANSMITTED ARE
TRUE.
_~9 7!
/~,~GNATURE~APPLICANT
~ame name as used in item
page 1. )
SUBSCRIBED AND SWORN TO BEFORE ME THIS .2~ DAY OF~~ 19
~ co~ss~oN ~~s ~-' ¢ ~. ~~~
' ' HOTLY
(PAGE 5)