CITY OF CHAPPELL, NEBRASKA

Instructions:
1. Fill out application form completely. Please print or type. Use additional sheets if needed.
2. Filing fee: $25.00. Make check payable to City of Chappell Treasurer.
3. Contact City of Chappell Zoning Administrator if you have any questions.
4. Submit a list of property owners within one-quarter mile, prepared by a certified abstractor.

1. Applicant's name: ____________________________________________________

2. Applicant's address: ___________________________________ ZIP: ___________

3. Telephone (business): _________________________ (home): ________________

4. Present use of property: _______________________________________________

5. Desired use of property: _______________________________________________

_________________________________________________________________

6. Present zoning: _____________________________________________________

7. Legal description of property: ___________________________________________

_________________________________________________________________

8. Under what provisions of the zoning regulations are you seeking this permit?

__________________________________________________________________

9. For how many years are you seeking this permit (5 years, 10 years, etc.)? ________

10. Explain in detail what you purpose to do: __________________________________

_________________________________________________________________

_________________________________________________________________

_________________________________________________________________

Application for Special Use Permit (Cont.)

11. How are adjoining properties used? Indicate both zoning district designations and
Actual uses.
North: ___________________________________________________________

South: __________________________________________________________

East: ___________________________________________________________

West: ___________________________________________________________

12. This authorizes the City of Chappell Zoning Administrator to enter upon the property during
normal working hours for the purpose of becoming familiar with the proposes situation. The Administrator may be accompanied by members the City Council, City Staff and/or the City Planning Commission.

____________ ____________________________________________________

Date - - - - - - - -Owner's Signature

-------------------------------------------------------------------------------------------

Comments

______________________________________________________________

______________________________________________________________

____________ ____________________________________________________

Date - - - - - - - -Zoning Administrator's Signature