72-116C
If
_. ....' ""\
* * If * * * * . it * it * '* * * * * *' * * w * * * * * * * * **
* FOR OFFICE USE ONLY _ ! / ,f' ~ *
*Board of Supervisors Case No. L '2- ~ I (p-.--,/' *
*Board of Zoning Appeals Fee Receipt No. *
*Planning Commission *
*Deferred to Deferred to Deferred to *
* * * * * * * * * * * * * * * * * * * * * * * * * * * * ~ * * *
APPLICATION TO THE CHESTERFIELD COUNTY BOARD OF SUPERVISORS OR
BOARD OF ZONING APPEALS
THE FOLLOHli\~G IHFOR~11J\TIon S~'~l\Ll 9E TYPED OR PRldTED AND COr~1PLETED Ii\l FULL
* * * * * * * * * * *
1.
2. A)
B)
C)
D)
E)
F)
G)
H)
I)
3.
EXPL~IN FULLY T~t'1EQUEST DESIRED
A)REL.ONING FROP1 ~~d--~4 / (., )
NA~ - NO.
B)USE PERMIT
TO :1i...,./ ." / .,
rrA~' ~ .....,,)~..r.,....,
C)VARIANCE
ORDINANCE SECTION
* * * * * * * * * * *
NAME OF APPLICANT~ c k.J=J,i':E L-tr..1~ to.. .~ t\ ~ Gp I....;.. .,.J
~~. ....... .,..,.~ ... -.. ......,~.~. ,. ,,~ I .1 (;1
MAILING ADDRESS :1' ., .. . p .
TELEPHONE NO · r.(.." '. );- .;.: ":?I:'~H^1nND VA Z:;-.., ~Ll
.... ~ jIIo? f!!" ~ ..0"'''1; . ,,- .. . - _,} At . -; .:r.
NA~1E OF PRESEi'JT(~O{~'r~ER 'Opr"PROPERTY 01~ \iHICH THIS REQUEST WILL
OCCUR: L. r .." ~ · ~-'~' (,,:. . ~ · ...1 (. .r, .~ to (,,)..., f'\ .. , . ,\I
. , , .. -. ~'Ii \. . :T "~ I - 0/. ~ ~ - i , T",
MAILING ADDRESS: , .' I... \.. . · :~: f. J~", ,-.J:~ V ..
TELEPHONE NO. :
NAf1E OF PERSOtJ TO BE ~~OTIFIED IF OTHER THAN APPLICANT AND/OR
PROPERTY OWNER: r;-:",; ':' '.Ai L! Ii.,:
ADDRESS: i'; ~~ .,...::,':..... ~'~I' '.-
TELEPHONE 1'10. : ". t~ fr - '., ~.
....... .r-
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* * * *'* * * * * * *
IF THE APPLICANT IS NOT THE OWNER OF THE PROPERTY IN QUESTION,
EXPLAIN: (Copy of pendin~ contract or option a~reement shall
be attached hereto and made a part of this application.)
* * * * * * * * * * *
4. LOCATION OF PROPERTY IN QUESTION
(Following information to be obtained from the
Office of the County Assessor)
A) r\1AGISTERIAL DISTRIC1:}) f'..f .':: B)TAX MAP NO;/ if< _ r .."
C) SEC. NO. D)SUBDIVISION NO. E)BLOCK O.'~ .
F) LOT OR PARCEL NO.~ _. . G)STREET ADDRESS
H) SOURCE OF TITLE F6R ALL PROPERTIES INVOLVED DEED BOOK ~~~-/
PAGE 7( >r
f\ PLAT OF THIS PROPERTY SHI',LL BE ATTACHED HERETO AND f'~!\OE A pr~RT OF THIS
APPlICJUION SHOHH!G THE LOCfHlmi BY REFERENCE TO j~EAREST ROP.D HJTERSECT
ION AND TUE DIHENSIONS 0F SITE.
* * * * * * * * * * *
1
,~
STATE THE REASON.R THIS REQUEST: d~ "et?...,...,."",/?~,~.
~ '\ J _. ~
/ <1L ~ -"Ir P " 2" ~ ~ 4 " ~ A..... .... o::'l~ -,/ ,..;.J p / .K2-""..- ./ V
;" / /' /
~ ~.D
-Il ,.- ~
?Il
* * * * * * * * * * *
6. STATE HOW THIS REQUEST ~JILL NOT BE MATERIALLY DETRIMENTAL TO THE
ADJACE~PROP~Y ~~NERS OR THE SURROUNDING NEIGHBORHOOD:
~# (. b~~-S ~ 14' ~ ~ ..4 t1/~"Ir,~ ~.~~- .t~ ~tJI1'\/d
~~~ ~~ -::~ U~,.~ ~~ ~:::;~~ ~~~~
-^ /~~H-;.4,~~ w E-c'"--/ ~:~ 'l~ "~U__:".__'~;" ~."~_ ~ -
.P A v,''''' 6- -"" /-'J' .". ~ ~ ~
* * * * * * * * * * *
7. STATE ANY EXISTING USE PERMIT OR VARIANCE GRANTED PREVIOUSLY ON
THE PARCEL IN QUESTION:
* * * * * * * * * * *
8. A) EXISTING LAND USE(S): M~ e
B) EXISTING STRUCTURES(S): /~~
USE: _......,
C) EXISTING ZONING: ~-1:'~.~,,4i#A ~ t
D) TOTAL ACREAGE OF THE REQUEST:
'* * * * * 2(. * *
9. GIVE NAMES OF ALL OWNERS ADJACENT, ACROSS THE ROAD OR HIGHWAY AND
FACING THE PROPERTY AtJD ANY Ol'Jl'JERS ACROSS ANY RAILROAD RIGHT-OF--
WAY FROM SUCH PROPERTY. IN THE EVENT THE PROPERTY AFFECTED IS
SITUATED AT OR WITHIN 100 FEET OF THE INTERSECTION OF ANY TWO OR
f'lORE ROADS OR I-!IGlfhr AYS, AT OR 1~lITI-IIN OJ'JE HUNDRED FEET OF TliE
INTERSECTION OF ANY ROAD OR HIGHWAY WITH A RAILROAD RIGHT-OF-WAY
OR AT OR WITHIN ONE HUNDRED FEET OF THE INTERSECTION OF THE RIGH~S-
OF-WAY OF ANY TWO RAILROADS, GIVE NAMES OF PROPERTY OWNERS AT ALL
CORNERS OF ANY SUCH INTERSECTION. (Following information MUST BE
obtained by trle applical1t from to. e office of the County Assessor..)
A) PROPERTY mINER'S NN1E: ~~4'~ 4 hJ./ t',..", 's.kd
~"lAILING ADDRESS 'ii.....~ ~ A..f /"
TAX MAP NO. : ~ SUBD.
LOT or PARCEL: BLOCK:
TYPE:
B) PROPERTY OWNER'S NAME:"
MAILING ADDRESS:
TAX ~.1AP I~O,,:
LOT or PARCEL:
C) PROPERTY OWNER'S NAME:
MAILltJG ADDRESS:
TAX r'1A.p NO;a :
LOT or PARCEL:
D) PROPERTY OWNERtS NAME:
I\1AILING ADDRESS:"
TAX r1AP NO.
LOT or PARCEL:
S liBD . N AfVIE :
BLOCK: SECTION:
SUBD. NAI\1E:
BLOCK: SECTION:
SUBDe NAME:
BLOCK: SECTION:
2
.
PROPERTY OWNER'S N~1E:
fil_A.ILII~G ADDRESS:
T AX ~1AP NO.:
LOT or PARCEL:
E)
.
BLOCI{ :
PROPERTY OWNER'S NAME:
~1AILI!~G ADDRESS:
TAX r~AP r~o.:
LOT or PARCEL:
F)
SUBD. NAME:
SECTION:
BLOCK:
PROPERTY OWNER'S NAME:
MAILI1~G ADDRESS:
T AX l-~AP r~o.:
LOT or P P~RCEL :
G)
SUBD.. NAr1E:
SECTION:
BLOCK:
PROPERTY OWNER'S NM1E:
r1AILING P.DDRESS:
TAX MAP NO. :
LOT or PARCEL:
l-I )
BLOCK:
PROPERTY OWNER'S NAME:
f\1AILING ADDRESS:
TAX MAP 1'10.:
LOT or PARCEL:
I)
J)
PROPERTY O~JNER i S
f'lAILING ADDRESS:
T AX MAP NO. :
LOT or PARCEL:
BLOCK:
PROPERTY OWNER'S Nffi1E:
riJAILING ADDRESS:
TAX r~~AP NO II :
LOT or PARCEL:
K)
SUBD. NAME: li
SECTION:
#V
(! "I
SUA3D 'P1~ ()
7 .17 f'ECTION :
l!(
NAr~1E :
SECTION:
SUBD. NAME:
SECTION:
BLOCK:
PROPERTY OWNER'S NAME:
r~1AILING ADDRESS:
TAX MAP NOa
LOT or PARCEL:
L)
SUBD. l~Af'~E:
SECTION:
BLOCK:
M) PROPERTY OWNER'S NAME:
TifIAILING ADDRESS:
TAX r~AP NO. :
LOT or PARCEL:
N) PROPERTY OWNERfS NM1E:
rv1AILING ADDRESS:
TAX J'v1AP r~o. ;
LOT 01" P flRCEL:
S.UBD. N1\r\1E:
SECTION:
3
SUBD. NAr~E:
BLOCK: SECTION:
SUBD. NMlE:
BLOCK: SECTION:
FOR ADDITIONAL SPACE USE THE BACK OF PAGES 3 & 4
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10) THE APPLICANT HEREWITH DEPOSITS. THE FEE REQUIRED~ A SCHEDULE IS
AVAILABLE IN THE PLANNING DEPARTMENT, ROOM 307.
11) CHECK OR MONEY ORDER MUST BE MADE PAYABLE TO:
TREASURER, COUNTY OF CHESTERFIELDe
12) I/WE HEREBY DEPOSE AND SAY THAT ALL OF THE ABOVE STATE~1ENTS AND
THE ST A TEr1Ei~T S CONT ArNE D I t~ l\.NY EXHIB ITS TRP,J~Sr~ I TTED ARE TRUE.
~-46~ ~ ~'-'
197.:z,
SIGNATURE OF AGENT
(Name of person other than, but
acting for the applicant, filling
out all or a part of this aDDli-
cation). .. ,I"
~()II/
(Same
2-A,
!-f
SUBSCRIBED AND SWORN TO BEFORE HE THIS ~ ~ -DAY OF~-4:J;_",,,
MY COMMISSION EXPIRES~~~ ~J7 1~.
19 7 ~--
1'10T ARY
4