GROWING COMMUNITY
Case No. ___
1.) Applicant – if owner(s), so state, if agent, tenant or other type of relationship, a letter of authorization must be furnished from the owner(s) with the application.
NAME: ___
MAILING ADDRESS: ___
TELEPHONE: ___
OWNER: (CHECK ONE) YES NO
OWNER: (CHECK ONE) ___YES ___NO
2.) Property Location: ___
3.) Legal Description: Lot(s)___ Block(s)___
Subdivision
*Please provide a separate metes and bounds description on a separate sheet.
4.) Existing Use of Property: ___
5.) Zoning: ___
6.) Give a brief explanation of reason for request:
7.) The undersigned hereby requests a minor plat of the above-described property as indicated.
Applicant/Agent Date
8.) Owner: ___
Name: ___
Mailing address: ___ Telephone: ___