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R OF USE ONLY
Case No. (7 1
Date Submitted
COMPREHENSIVE PLAN AMENDMENT APPLICATION
(Check all applicable) Land Use Amendment ❑ Thoroughfare Amendment
❑ alignment / location
❑ classification
The following items must be submitted by the established deadline dates for consideration:
X Two (2) copies of a fully dimensionedV244,"6" paper showing:
a. Landaffected;
b. Present zoning of property and zoningn of all abutting properties;
c. Current land use plan classification andand use plan changes;
d. Current land use classification of all abutting property;
e. Current and proposed thoroughfare alignments
General location and address of property;
,OQ Total acres of property; and
jiQ All applicable Comprehensive Plan Amendment Request form(s) completed in full.
The following information must be completed before an application is accepted for review.
APPLICANT INFORMATION:
(if diffe a roryl�ownika
Name: % dJJYY��//
Street Address: 411 Z
City:/ s
Phone Number:
PROPERTY OWNER'S
Names 044AM:
Street Address:
City: EA
Phone Number:
affidavit shall be required)
W E-mail:
Number: _'f_M_ (R 3
TION: A
/w E-mail:��'/
/E
_State: 7r:�( Zip Code: V
12249 Fax Number: 91W K3 ()A] 41
6/13/03
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