---

ALL APPLICATIONS ARE DUE BY 11:59 PM ON THE DEADLINE DATES. It is highly recommended that the property owner and/or their representative meet with staff prior to submitting an application.

---

Nature of Request and Fees

Please select the request from the drop down list below:
*

Variance--$200.00 Appeal of an Administrative Decision-$200.00

---

Requirements: All support documentation must be submitted in 8 1/2 x 11 plan sheets as a single portable digital format (pdf) along with this application and appropriate fee.

Owner of Property*

Property Address:*

Home Phone:*

Cell Phone:

Work Phone:

Email address:

Representative for Request:*

Representative Phone number:*

Representative Email Address:

---

Description of Request

Applicable code sections:*

Description of Request and Comments:*

Please attach plan sheets and all supporting documentation as a single pdf below:*

Convert to PDF?
(DOC, DOCX, XLS, XLSX, TXT)

---

Information of person completing form and electronic signature

I certify that I am the owner or serve as the owner's representative and am duly authorized to complete this applications. I certify that all information required for review of this submittal is included. If the application is found to be incomplete, the primary contact will be notified and the application removed from the agenda. I understand that selecting the box below will serve as my electronic signature and agreement of this statement.*

I Agree

Name:*

Date application completed:*

Address:*

Phone number:*

Email Address:*