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Cfty of South Bend <br />BOARD OF ZONING APPEALS <br />Petition for Variance - Special Exception <br />Property Information <br />Tax Key Number: q 77 5 <br />Address: <br />Owner:tJye Wl I er ra4e j' f`)/ C Of'j?gel n V <br />Zoning: Choose the current district <br />Project Summary:Con yAfer/I a-' 5-tn Fo-M y <br />OKC tO 6 <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 />Filed in Clerk's Office <br />MAR U 8 2022 <br />4 <br />pq'WN P 1.JOf S <br />CITY CLERK,SOUTH BEND,IN <br />Required Documents <br />Completed Application (including Criteria for Decision Making and Contact Information) <br />Site Plan drawn to scale <br />Filing Fee