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BOARD OF SUPERVISORS <br /> CHESTERFIELD COUNTY <br /> CHESTERFI ELD, VA. <br /> <br />For Office Use Only: <br />Case No. ,7~)"S~ Z~' <br /> <br />Fee Receipt No. ~¢1 <br /> <br />~ RECE~;[,D~ ~t~c~o. ~o~ <br />~- CHEST[ '= ~ COUHTY~/ (N~ ~ RE~); <br />~1~, ~m,"2~~llowing infomation~tt~ed or printed) <br /> (Must be o~er & occupant of%the Mobile Hme) <br /> 2. ~dress of Applicant <br /> <br /> Su~. N~o ~t/Parcel / Blk. Sec. <br /> <br />A map of this property must be attached to this application° <br />This map must be to scale. <br /> <br />5. Name~of owner of property on which mobile home will be parked <br /> <br /> ("i .e applicant is'not wner of the pr6perty in question, <br /> explain.) ~.,, '~.N~-N-%~ ~%.0~ ~ ~ \o.~ei <br /> ~ ~,',~ ~ 1 o,~,'~. ~*r~.~ ,~,, ~,~ ~~- <br />6. If mObile h~e will ~emain un~cupied, explai~ ..... - . ' <br /> <br />7. Time requested for mobile home to remain at site (use permit <br /> <br /> granted for a maximum of two years only.) <br /> months / years <br /> <br />8. Size and type of mobile home to be parked on the above noted <br /> <br />e <br /> <br />property. Make~o%a~,x,,~rModel <br />Length ~0! No. of Bedrooms ,,\ <br /> <br />Source of water supply <br /> <br />Color c~v~ /t.o%.,.~-~, Width <br /> -~3 \1 <br />NO. of Bathrooms ~ <br /> <br />,, <br /> <br />Method of sewage disposal <br /> <br />Information obtainable from the office of the County Assessor. <br />(Room 213) <br /> <br /> <br />