All Other Requests/ Public Hearing Items
Applicant Name*
Mailing Address*
Applicant City, State, Zip*
Applicant Telephone*
Applicant Email Address*
Lot Area
Current Use*
Proposed Use*
Is the lot a corner lot?
Type*
Describe the nature of the request - staff will contact you with more information and for further assistance
**E-signature***
By typing my name in the **E-signature** box above, I hereby certify that the information and attachments provided are true and accurate to the best of my knowledge.
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