PORT SHELDON TOWNSHIP

SPECIAL USE APPLICATION

 

FILING FEE $400.00 (if  site plan not required)

 

A SITE PLAN AND BUILDING PLANS MUST BE SUBMITTED

WITH THIS APPLICATION.




TO THE PLANNING COMMISSIO C/O The Zoning Administrator. Application is hereby made pursuant to the provisions of the Zoning Ordinance.

Name of Applicant _________________________________________Phone____________

Mailing Address of Applicant_____________________________________________________

_____________________________________________________________________________

Address of Property In Question__________________________________________________

Parcel Number of  Subject Property____________________________________Zoning______

Applicants Interest in Property____________________________________________________

Name of Owner________________________________________________________________

Address of Owner_____________________________________________Phone___________

Present use of Structure/Premises_________________________________________________

Proposed Use of Structure/Premises________________________________________________

Size of Existing/Proposed Structure________________________________________________

Description of  Existing/Proposed Structure__________________________________________

_____________________________________________________________________________


Describe the nature of your request_______________________________________________

_____________________________________________________________________________

_____________________________________________________________________________

_____________________________________________________________________________

If there has been a previous request involving the existing structure/premises, state the date of filing, character of request and disposition of same.____________________________________

_____________________________________________________________________________

_____________________________________________________________________________

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Signature of Applicant or Agent