72-45cs1) A)
B)
C)
D)
E)
F)
2) IF
EXP
be
3)
A)
C)
F)
A ~
OF
The
NAME OF APPLICANT:
MAILING ADDRESS:
TELEPHONE NO.:
*For office e only
*CASE NO. ·
*REVIEW BY P. C.
APPLICATION FOR AMENDMENT TO THE
CHESTERFIELD COUNTY ZONING ORDINANCE
follo~n[ Infoma~on 5s go be gTped o~
MAILING ADDRESS:
TELEPHONE NO.:
NAME OF PRESENT OWNER OF PROPERTY ON WHICH THIS REQUEST WILL
OCCUR:
......
!HE APPLICANT IS NOT THE OWNER OF THE PROPERTY IN QUESTION,
jAIN: (Copy of pending contract or option agreement shall
Lttached 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.
/7
SEC. NO. ~ D) SUBDIVISION NO. E) BLOCK NO.
LOT OR PARCEL NO. ,,,, G) STREET ADDRESS 115OI
LAT 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
(PAGE 1)
5)
6)
7)
8)
TH!
RE(
ST~
ST.
TH'~
ST
TH
EX
PETITIONER REQUESTS THAT THE ZONING ORDINANCE BE AMENDED TO
LASSIFY THIS PROPERTY FROM
- / NO./NAME NO~/'NAME
,TE THE REASON FOR THIS REQUEST:
~TE HOW THIS REQUEST WILL NOT BE MATERIALLY DETRIMENTAL TO
ADJACENT PROPERTY OWNERS OR THE SURROUNDING NEIGHBORHOOD:
kTE ANY EXISTING USE PERMIT OR VARIANCE GRANTED PREVIOUSLY ON
PARCEL IN QUESTION:
STING LAND USE:
(PAGE 2)
9)
GIt
AN]
OF
IS
TW~
OF
OF
TH
OW
A)
B
D
E NAMES OF ALL OWNERS ADJACENT, ACROSS THE ROAD OR HIGHWAY
FACING THE PROPERTY AND ANY OWNERS ACROSS ANY RAILROAD RIGHT_
WAY FROM SUCH PROPERTY° IN THE EVENT THE PROPERTY AFFECTED
SITUATED AT OR WITHIN 100 FEET ON THE INTERSECTION OF ANY
OR MORE ROADS OR HIGHWAYS, AT OR WITHIN ONE HUNDRED FEET
THE INTERSECTION OF ANY ROAD OR HIGHWAY WITH A RAILROAD RIGHT-
.WAY OR AT OR WITHIN ONE HUNDRED FEET OF THE INTERSECTION OF
RIGHTS-OF-WAY OF ANY TWO RAILROADS, GIVE NAMES OF PROPERTY
ERS AT ALL CORNERS OF ANY SUCH INTERSECTION.
MAILING ADDRESS: ///~,/ ,~/'~/~/~-/
TAX MAP NO.: i7 SEC. NO.:~ 7 SUBDIVISION NO.:
BLOCK NO.: LOT OR PARCEL NO.:
MAILING ADDRESS: ~, ~ ~;Kg~/~~ ~~ -
~x M~ NO,: I7 S~, NO,:~ SUB~IVmSION NO,:
BLOCK NO.: LOT OR PARCEL NO.:
T~x ~A~ NO,: ;Q S~S, NO,:~ SUBDIVISION ~0,:
BLOOK NO.: LOT OR PARgEL NO.:
MAILING ADDRESS:
TAX MAP NO.:
BLOCK NO.:
SEC. NO.: ~ SUBDIVISION NO.:
LOT OR PARCEL NO.: /~)
(PAGE 3)
E)
F)
G)
H)
I)
J)
TAX MAP NO.: /'7 SEC. NO.: c~ SUBDIVISION NO.:
BLOCK NO.: LOT OR PARCEL NO.:
MAILING ADDRESS
TAX MAP NO.: I'7
BLOCK NO.:
SEC. NO.: ~ SUBDIVISION NO.:
LOT OR PARCEL NO.:
PROPERTY OWNER' S NAME:
MAILING ADDRESS:
TAX MAP NO.: Iq
BLOCK NO.:
SEC. NO.: ~ , SUBDIVISION NO.:
LOT OR PARCEL NO.: .... l Y-~
PROPERTY OWNER'S NAME: ~f1~1/%A L ' ~ ~ ~-.
MAILING ADDRESS: .'Tf) ~ ~ ' ~t3 ~~U ~ ,,~~
TAX MAP NO.: I 9 SEC. NO.: _ ...... ;~ SUBDIVISION NO.:
BLOCK NO.: LOT OR PARCEL NO.: ...... /O
PROPERTY OWNER'S NAME:
MAILING ADDRESS:
TAX MAP NO.:
BLOCK NO.:
SEC. NO.: SUBDIVISION NO.:
LOT OR PARCEL NO.:
PROPERTY OWNER'S NAME:
MAILING ADDRESS:
TAX MAP NO.:
BLOCK NO.:
SEC. NO.: SUBDIVISION NO.:
LOT OR PARCEL NO.:
(PAGE 4)
lO)
T
T:
T~
{E APPLICANT HEREWITH DEPOSITS THE SUM OF TWENTY DOLLARS
~20.00) ATTACHED TO THIS APPLICATION, TO PAY THE COST OF
)VERTISING NOTICE OF THE HEARING OF SAID BOARD TO ACT ON
lIS REQUEST. CHECK OR MONEY ORDER MUST BE MADE PAYABLE
: TREASURER~ COUNTY OF CHESTERFIELD.
WE HEREBY DEPOSE AND SAY THAT ALL OF THE ABOVE STATEMENTS
ID THE STATEMENTS CONTAINED IN ANY EXHIBITS TRANSMITTED ARE
~UE.
BSCRIBED AND SWORN TO BEFORE ME THIS/.Z~ ~,~..~OP .~ 19,7'
COMMISSION EXPIRES /~--- '
,dT:.
SIGNATURE OF A'~LICANT
(Same name as used in item l-A,
page 1. )
Clover
il
400
SCALE IN FEE*i
0 '~iO0 800 1200 1600