PETITION FOR SPECIAL USE PERMIT

VILLAGE OF ST. JOSEPH

P.O. BOX 716

207 E. LINCOLN STREET

ST JOSEPH, IL 61873

217-469-7371

217-469-7019 (FAX)

1.                  Name of Applicant:________________________________________________

Address:__________________________________________________________

__________________________________________________________________

Phone #:____________________

2.                  Name of All Owners:_______________________________________________

Address__________________________________________________________

__________________________________________________________________

Phone #:_____________________

3.                  Street address of property

4.                  Legal description of property (include map):

5.                  Current Zoning of Property:

6.                  Special Use Requested:

7.                  Reason for Request:

8.                  Why is current zoning inadequate?

9.                  Explain why special use will not be detrimental to neighborhood and Village.

10.              What is intended use of premises or improvements?

Date Filed:_____________________                                   _______________________

Fee Paid:_______________________

Zoning Board of Appeals:  Approved____________      Disapproved____________

Planning Commission:        Approved____________      Disapproved____________

Board of Trustees:                Approved____________      Disapproved____________