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... ,.'. ,'_~ ~,: :~ ',' , ..... <br />~[ * :'" :I'..:"'.' FOR OFFICE USE ONLY <br /> - -~'~: ....... ~'~ ~ Case No. ' " ~' , <br /> ~v~~~f Zon~n~ appeals Fee ~ecelpt No. <br /> <br /> APPLICATION TO THE CHESTERFIELD COUNTY BOARD 0F SUPERFISORS OR <br /> BOARD OF ZONING APPEALS <br /> FOLLOWING INFORM~TION SHALL BE TYPED OR PRINTED AND COMPLETED IN FULL <br /> <br /> E~PLAIN FULLY THE REQUEST DESIRED <br /> A) REZONING: From ~': ' ( ) To ~ '~ ~ <br /> Type of use(s~ proposed: - ' ~ ' ~. ( ) <br /> <br />B) C ........... <br /> ONDITIONAL USE: <br /> <br />c) VA~ <br /> <br /> A) <br /> B) <br /> <br />D) <br /> <br />E) <br /> <br />H) <br /> <br />NAME OF APPLICANT: <br />MAILING ADDRESS: <br /> <br /> OCCUR: <br /> MAILI~ ~ <br /> '-.~ ~" %:..~, , v..::: ...... F PHONE NO.: <br /> N~E OP PEHSON TO ~E NOTIFIED ~ OTHER ~HAN ~PPLIC~NT ~ND/OR <br />PROPERTY O~NER: ~.. ~ ~ ,_..~ ...... <br />ADDRESS: -' ~; ~ .~ ~,~ ..... .,. <br /> <br /> .... I) --TELEPHONE NO.: <br /> <br />IF THE APPLICANT IS NOT THE OWNER OF THE PROPERTY IN QUESTION, <br />EXPLAIN: (A ~ of pending contract or option agreement shall <br />b~ attached hereto and made a part of this application.) <br /> <br />A) <br />C) <br />~) <br />~) <br /> <br /> LOCATION OF PROPERTY IN QUESTION <br /> (Following information shall be obtained from the <br /> Office of the County Assessor, Room 213) <br /> <br />MAGISTERIAL~DISTRICT <br /> - ~ ' B) TAX MAP NO.__ <br />SEC. NO. ~:~?~ D) SUBDiVISI09 NO E) BLOCK <br />LOT OR P~ .~ G) S .... NO. <br /> TREET ADDRESS -- <br />SOURCE OF TITLE F0-~L PROPERTIES INVOLVED DE~D Book ,,.,,~_:, <br />PAGE !~:i~ '.~.~ ..... <br /> <br /> <br />