APPENDIX C: PETITION FOR ZONING CHANGES, VARIATION OF EXCEPTION

   Dated:                                                        

Petition #                                 Ordinance #   

Name(s) of Applicant(s):    

Address of Applicant(s):    

City:                               State:                Zip Code:   

Name(s) of Owner(s):    

Address of (Owner(s):          

City:                               State:                Zip Code:   

Contact Person:                         Phone #:    

Legal Address or Address Range:    

Present Zoning:                         Requested Zoning:    

Present Use:                          Requested Variance:    

Present Restriction:                       Requested Exception:    

Reason for the Requested Zoning, Use or Construction Exception:    

Narrative Description of Requested Changes Sought By This Petition (additional sheets may be attached):

ATTACH A COPY OF RECORDED DEED WITH CURRENT AND CORRECT LEGAL DESCRIPTION

I/We affirm under the law and the penalties of perjury that the foregoing is true to the best of our own knowledge and understanding this        day of                      , 20   :

Signature of Applicant                      Signature of Owner

Printed Name of Applicant                   Printed Name of Owner

Signature of Owner                        Printed Name of Owner

Owner(s) affirm, acknowledge and agree that should the requested change of zoning, variance or exception be granted that he/she shall be bound by the terms of said zoning change, variance or exception as same may be granted.

Dated:                                     

                                    Signature of Owner

Dated:                                     

                                    Signature of Owner

(Ord. 07-01, adopted 5-5-2007, updated 5- -2009, Appendix)