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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 <br />d l - , 0 3 S -- i SOg RECEIVED JUL 10 7023 <br />Tax Key Number: <br />D J <br />Address: <br />I L <br />f <br />Owner: - -12I `t,0- <br />Zoning: Choose the current district ik, J <br />Project Summary: <br />44,\,* <br />11 O e7 <br />v <br />o---T <br />i - ' <br />1pi <br />bc,L.c <br />e- Imo- <br />Requested Action <br />Special Exception — comple e and attach Criteria for Decision Makin <br />Use requested: • V' C, r Ye) <br />l ,4A45f <br />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 <br />Contac9 / <br />forr atiop) <br />Df'p"""'Site Plan drawn to scale CviQ( 1( ` j0( <br />1 I Filing Fee Ill) 11) : ' ; <br />Per x• (A- <br />1/- <br />4-0- <br />ii <br />A- -y