APPENDIX C: PETITION FOR SPECIAL USE
   VILLAGE OF CHATHAM, ILLINOIS
   PETITION FOR SPECIAL USE
TO:   Chatham Planning Commission and
      Village Board
      Village Hall
      Chatham, IL 62629                  Date:                         
   [DO NOT WRITE IN THIS SPACE - FOR OFFICE USE ONLY]
Date Set for Hearing                                    Fee $               
Notice published                                     Date Paid                
Newspaper                                   
Notice Mailed to Adjacent Landowners                                         
Notice Posted on Subject Property                                            
Planning Commission      Date              
   Recommendation                  Village Board Action         Date       
Approve                         Denied
Deny   Chairman Initials                Approved (Ordinance No.       -       )
Approve with Modification
INSTRUCTIONS TO APPLICANTS: All information required by this Application must be completed and submitted herewith. Applicants are encouraged to visit the Village office for any assistance needed in filling out this form. See Section 7.07 of the 1994 Zoning Ordinance, and district regulations in the Zoning Ordinance for further details.
NAME OF APPLICANT:                                                                                                      
ADDRESS OF APPLICANT:                                                                                                  
PHONE NUMBER:                          (H)                                         (W)
Interest of Applicant In the Subject Property (if not owner):                                                                                                                                                              
1.   This application must be filed with an accurate legal description and a plat map of the property drawn to scale not less than one (1) inch equals Two Hundred (200) feet.
   LEGAL DESCRIPTION                                                                               
                     Lot, Block, Subdivision, Metes and Bounds--may be on attachment
2.   Street Address of Property                                                                       
3.   Area of land re-zoning requested for:                           square feet.
4.   (a)   Present Zoning District Classification of subject and adjacent properties (show zone district boundaries on plat):                                         
   (b)   Requested New Zoning District Classification of Adjacent Property:                  
5.   Present use of Property:                                                                          
   Proposed use of Property:                                                                         
6.   Names, addresses and phone numbers of all owners of record:
                                                                                                                      
                                                                                                                       
                                                                                                                       
                                                                                                                       
                                                                                                                       
                                                                                                                        
7.   A special use permit is requested for the subject property. A statement of the applicant's described reasons and factual information supporting the requested special use is attached.
DATE:                                       SIGNATURE:                                          
OWNER'S CONSENT
[This part need be signed only if the applicant is different from the owner or if there is more than one owner of record]
   I consent to this requested zoning change