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City of South Bend 227 W. Jefferson - Suite 1400S <br /> South Bend, IN 46601 <br /> BOARD OF ZONING APPEALS zoning@southbendin.gov <br /> Petition for Variance - Special Exception <br /> Property Information d l - , 0 3 S -- i S Og RECEIVED JUL 10 7023 <br /> Tax Key Number: D J <br /> Address: I L f <br /> Owner: - - : <<, 12I `t,0- <br /> Zoning: Choose the current district ik, J <br /> Project Summary: >>, ��-�--�` 44,\,* <br /> 11 O e7 v o---T <br /> �\i - ' 1pi <br /> bc,L. c � �'---e-� Imo- <br /> Requested Action <br /> Special Exception — comple e and attach Criteria for Decision Makin <br /> Use requested: • V' C, r Ye) l �,4A45 <br /> f Variance(s) - List variances below, complete and attach Criteria for Decision Making <br /> Variance(s) requested: <br /> Required,Documents <br /> FV/Completed Application (including Criteria{� � � for Decision Making and Contac9 /�forr atiop) D <br /> f�'p""�"' <br /> Site Plan drawn to scale CviQ( 1( ` j !�,0( <br /> 1 I Filing Fee <br /> Ill) 11) : ' ; <br /> Per x• (A-1/-4-0- <br /> ii <br /> A- -y <br />