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City of South Bend 227 W. Jefferson - Suite 1400S <br /> South Bend, IN 46601 <br /> BOARD OF ZONING APPEALS <br /> zoning@southbendin.gov <br /> SpecialPetition for Variance - - . . <br /> Property Information 018-7105-3763 <br /> Tax Key Number. �z — <br /> Address: _ <br /> Owner: — � �d.�rt+� IVlpt`� c flc. -� i is <br /> Zoning: Choose the current district � ^�l (�L2 <br /> Project Summary: <br /> I9 0 t C'a, Vbr,+ S+ 403 <br /> Tw-o �R-kxt(� CLAI C&O-1-1 k &iA, rkb+ 0. <br /> Requested Action <br /> ❑ Special Exception - complete and attach Criteria for Decision Making <br /> Use requested: <br /> ❑ Variance(s) - List variances below, complete and attach Criteria for Decision Making <br /> Variance(s) requested: <br /> Required Documents <br /> ❑ Completed Application (including Criteria for Decision Making and Contact Information) <br /> ❑ Site Plan drawn to scale —� <br /> in Clerk's Office <br /> ❑ Filing Fee <br /> ! 0 F 202Z <br /> f /,1"dlJ M.JONES <br /> �C,:----F;K, SOUTH BEND, IN <br />