GROWING COMMUNITY

Case No. ZSE-

APPLICATION FOR ZONING SPECIAL EXCEPTION (ZSE): FEE: $500- Payable to the City of Balch Springs

DATA RELATIVE TO ZONING SPECIAL EXCEPTION REQUEST:

PROPERTY INFORMATION:

1.) Street Address: ___

Lot number: ___ Block number: ___ Addition: ___

Zoning District: ___

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

TO THE HONORABLE BOARD OF ADJUSTMENTS:

APPLICANT INFORMATION:

2.) ___

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2.) Applicant's Name

Applicant's Name

Applicant's Street Address City State Zip Code

Telephone Number

PLEASE COMPLETE THE FOLLOWING IF OTHER THAN THE APPLICANT:

3.)

___

Property Owner Telephone Number

Street Address City State Zip Code

4.)

Tenant Name Telephone Number

Street Address City State Zip Code