HomeMy WebLinkAbout1967-05-18 Application for Special Use Permit(Complete in Duplicate)This form to be used in all applications for special use permits and for rezoning, dividing or consolidating parcels of land, vacating streets, alleys and variances.
DateType of Application
Owner of Property: Name k'"/) rr( n Phone No.
Address <■ / h / _ _ _ _
Applicant (other than owner): Name
Address
Phone No.
Relationship to Owner
Engineer: Name_ _
Land Planner: Name
Subdivider: Name
Phone No.
Phone No.
Phone No.
Location (How do we find it?)
Legal Description: /4/ hA^rvI (ic/cK
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Date of last division of this property_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Do you own any adjoining property
Action Requested >/^-1- '
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Signature of Applicant
RECORD OF ACTION TAKEN
Date Action
Inspection Deptl:
Administrator:
Village Council:
Village Engineer:
Village Attorney:
Planning Commission:
Village Council:
Permit Issued: Date
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