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City of South Bend 227 W. Jefferson - Suite 14005 <br /> 01 <br /> BOARD OF ZONING APPEALS South Bend, IN edin <br /> zoninq@southbendin.gov <br /> Petition for Variance - Special Exception <br /> Property Information <br /> 01 -ao ._ Qci <br /> Tax Key Number: <br /> Address: s°6 /41, r Lr tv>� <br /> Owner: 444- to;1/1•4-,--' <br /> S <br /> Zoning: Choose the current district <br /> Project Summary: <br /> £do <br /> 01.an <br /> 45)1+. -9../i)eP19- <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 /> aiVA c)2') ONeVkin aecr3/1/0 <br /> (57L) C370 - <br /> LQ L <br /> ' PAID AUG 17 2072 <br /> Required Documents <br /> ❑ Completed Application (including Criteria for Decision Making and Contact Information) <br /> ❑ Site Plan drawn to scale <br /> ❑ Filing Fee Filed in Clerk's Office <br /> FSI-El-) 0 7 ?0?? <br /> DAWiV M.JONES <br /> CITY CLERK, SOUTH BEND,IN <br />