72-41cs1) ^)
B)
c)
D)
2)
3)
E)
F)
IF '
EXP
be
^)
c)
F)
AP
OF
*For office t~ on__q~ *
, ,
*CASE NO. ~
*REVIEW BY P.C. *
APPLICATION FOR AMENDMENT TO THE
CHESTERFIELD COUNTY ZONING ORDINANCE
The followln~ infor~nation is to be typed or
NAME OF APPLICANT: ~~~ ~ ~f~~~
MAILIN~ ADDRESS: /~ ~/~/~ ~,,~
NAME OF PRESENT OWNER OF PROPERTY ON WHICH THIS REQUEST WILL
occuR:,
MAILIN8 ADDRESS:, /.~ ~..,~'~,,~ ,~'~, ,~
TELEPHONE NO.: ~2 7~- 6' ~.,~.f"
!HE APPLICANT IS NOT THE OWNER OF THE PROPERTY IN QUESTION,
JAIN: (Copy of pending contract or option agreement shall
tttached hereto and made a part of this application.)
LOCATION OF PROPERTY IN QUESTION
Following information to be obtained by the applicant
from the Office of the County Assessor)
MAGISTERIAL DISTRICT~,'~/~//~ B) TAX MAP NO. /8
SEC. NO. /~ D) SUBDIVISION NO. E) BLOCK NO.
LOT OR PARCEL NO. ~ G) STREET ADDRESS~o ~RD ~mZ~
~AT OF THIS PROPERTY SHALL BE ATTACHED HERETO AND MADE A PART
~HIS APPLICATION SHOWING THE FOLLOWING:
LOCATION BY'REFERENCE TO NEAREST ROAD INTERSECTION
DIMENSIONS OF SITE F/-~ 6-~ ~
(PAGE 1)
5)
6)
7)
,~ET3U~ON~R R~U~STS THA~ THE ZONING ORD~NANC~ BE AMENDED TO
tSSI~ TH~S PROPERTY FRO~ ~ ~'~,~/ TO ~ / , .
' ' ' ~NO./~A~ - ~ ........ N0./NA~ "'
STA%TI~ R~ASON FOR T. HIS REQUEST: .............................. ,, .._
STA~
THE
THIS REQ.UEST WILL NOT BE MATERIALLY DETRIMENTAL TO
~DJACENT PROPERTY OWNERS OR THE SURROUNDING NEIGHBORHOOD:
STA¶
EXI~
E ANY EXISTING USE PFFJ~i~T OR VARIANCE GRANTED Pi~EVIOUSLY ON
PARCEL iN QUESTIOM:
TINQ LA}D USE:
(PAGE
9)
GIVE
AND
OF W~
IS SI
TWO
O~ ~
OF-W~
.THE
OWNE
~tAMES O~ ALL OWNERS ADJACENT, ACROSS THE ROAD OR HIGHWAY
~CING THE PROPERTY AND ANY OWNERS ACROSS ANY RAILROAD RIGHT_
FROM SUCH PROPERTY. IN THE EVENTTHE PROPERTY ~F~ECTED
rUATED AT OR WITHIN 100 FEET ON THE INTERSECTION OF ANY
MORE ROADS OR ~IGHWAYS, AT OR WITHIN ONE HUNDRED FEET
INTERSECTION OF ANY ROAD OR HIGHWAY WITH A RAILROAD RIGHT'
OR AT OR WITHIN ONE HUNDRED FEET OF THE INTERSECTION OI~
IGHTS-OF-WAY OF ANy TWO RAILROADS, GIVE NAMES OF PROPERTY
S AT ALL CORNERS 0P ~J~Y SUCH INTERSECTION.
'~ ~P NO.: /~ SEC. NO.'
.~CK NO.: LOT OR PARCEL NO.: ~ /~ ..
~LOCK NO.: ..... , , , L~ OR PARCEL NO.: ......
~flX ~P NO.: SEC. NO.: S~DI'~SION NO.: ........
~LOCK NO.: L~
E)
G)
H)
I)
J)
~ROPERTY OWNER'S NAME:
NAILING ADDRESS:
MAP NO.: SEC. NO.:
SUBDIVISION NO.:
~ ',OCK NO.:
LOT OR PARCEL NO.'
~OPERTY OWNER' S NAME:
AILING ADDRESS:
IAX MAP NO.: SEC. NO.:
SUBDIVISION NO.:
LOCK NO.:
LOT OR PARCEL NO.:
ROPERTY OWNER' S NAME:
AILING ADDRESS:
AX MAP NO.: SEC. NO.:
SUBDIVISION NO.:
LOCK NO.: LOT OR PARCWL NO.:
ROPERTY OWNER'S NAME:
iAILING ADDRESS:
AX MAP NO.:
SEC. NO.:
SUBDIVISION~ NO.:
LOCK NO.:
LOT OR PARCEL NO.:
ROPERTY OWNER' S NAME:
AILING ADDRESS:
~AX MAP NO.:
SEC. NO.:
SUBDIVISION NO.:
~LOCK NO.:
,LOT OR PARCEL NO.:
[AILING ADDRESS:
!AX MAP NO.:
;LOCK NO.:
SEC. NO.: SUBDIVISION N0.:
LOT OR' PARCEL NO.:
(PAGE 4)
THE
(Sec
ADVE
THIS
TO:
~PLICANT HEREWITH DEPOSITS THE SUM OF TWENTY DOLLARS
00) ATTACHED TO THIS APPLICATION, TO PAY THE COST OF
(TISIN8 NOTICE OF THE HEARING OF SAID BOARD TO ACT ON
REQUEST. CHECK OR MONEY ORDER MUST BE MADE PAYABLE
TREASURER~ C0~TY OF CHESTERFIELD.
I/wE
AND
HEREBY DEPOSE AND SAY THAT ALL OF THE ABOVE STATEMENTS
PHE STATEMENTS CONTAINED IN ANY EXHIBITS TRANSMITTED ARE
SUBS
MY C
(Same na_,ne as used in item l-A,
page 1. )
~IBED AND SWORN TO BEFORE ~. ~ S /~/ D^~ 0~, ~J~--
D~ISSION EXPIRES~ , ~ .... ~
o
o