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2. Applicant(s) Name:
4. First Name*
5. Last Name*
7. Address*
9. City*
10. State*
12. Zip Code*
13. Phone Number*
15. Email Address
19. Application or request to the Planning and Zoning Commission for the following purpose*
    -- Select One --RezoningSpecial UseSubdivision
21. Requested Zoning classification of area:
22. Present Zoning Classification of Area:
24. Legal description of the affected area:*
26. Is property included in the Historic Preservation district*

    1. Yes
    2. No
28. Note: If you are planning an exterior building or renovation project, you will need a certificate of appropriation from the Historic Preservation Commission
30. Are you the owner of the property?*

    1. Yes
    2. No
32. If no, do you have a good faith agreement that shows you will be purchasing the property in question and are authorized to request action on the owners behalf?

    1. Yes
    2. No
34. Reason for application or request*
36. Provide narrative of proposed development of betterment*
38. Describe present use of property involved in the application*
40. Good faith agreements, photos, property mailing list, etc
42. Miscellaneous documents (addresses, etc
43. Miscellaneous documents (site plans etc)
44. Miscellaneous documents (good faith agreements etc)
46. Public Hearing Date
    Action on this application will require notice of public hearing. Requirements include: notice of hearing mailed by certified mailing 20 days prior to meeting, notice on the property at least 20 days prior, and notice in a local newspaper 15 days prior
48. The Planning and Zoning Commission meets in regular session on the first Tuesday of each month as determined by agenda items requiring action.
50. Application Fee
    Must be paid prior to the public hearing, unless told otherwise, the applicant shall pay to the secretary of the Planning and Zoning Commission a sum equal to the cost of publication, certified mailing of the notice of public hearing, and any fee set by the city, failure to do so will result in cancellation of hearing or rescinding of permit approval
52. Electronic Signature Agreement

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
54. Electronic Signature
Leave This Blank:


56. 1. Receive an email copy of this form.
57. Email address

    This field is not part of the form submission.

58. Submit Submit and Print

* indicates a required field