GROWING COMMUNITY

Case No. _____

APPLICATION FOR ZONING CHANGE

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

2.) Property Location: ___

3.) Legal Description: ___ Block(s) ___ Subdivision ___

*Please provide a separate metes and bounds description on a separate sheet.

4.) Existing Use of Property: ___

5.) Give an explanation of the proposed use of the property and attach supporting information:

6.) Zoning Request: From: ___ To: ___

7.) Give a brief explanation of reason for the request: ___

8.) The undersigned hereby requests rezoning of the above-described property as indicated. Applicant/Agent Date

9.) Owner: ___ Name: ___ Mailing address: ___ Telephone: ___ Signature ___ Owner ___ Date ___