THE CITY OF

BALCH SPRINGS

GROWING COMMUNITY

OFFICE USE ONLY Date Received:

Complete this application in its entirety and submit pages 4 and 5 along with the required materials (including any required supplements) as listed on page 2 to the address below:

City of Balch Springs

Planning & Zoning Department

13503 Alexander Road

Balch Springs, Texas 75181

Case Number: DP ___ - ___ ___ ___

1. PROPERTY INFORMATION

Address or Location ___

Legal Description _____ Zoning District _____

Current Land Use ___

Proposed Land Use ___

The proposed use will be in: ☐ an existing building ☐ a new addition ☐ a new building

2. PROPERTY OWNER INFORMATION (an individual or a legal entity may be listed as owner)

Owner's Name ___

Address ___ City ___ State ___ Zip ___

Phone ___ Email ___

3. APPLICANT INFORMATION (if different from owner)

Applicant's Name ___

Address ___ City ___ State ___ Zip ___

Phone ___ Email ___

4. APPLICANT AGENT INFORMATION (if different from applicant)

Agent's Name ___

Address ___ City ___ State ___ Zip ___

Phone ___ Email ___