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2. APPLICANT/REPRESENTATIVE INFORMATION:
4. First Name*
5. Last Name*
7. Address*
8. Email*
10. City*
11. State*
12. Zip*
13. Phone #*
15. PROPERTY OWNER INFORMATION:
17. Owner's Name [if different from above]
18. Email*
19. Phone #*
21. Property Address*
22. Zip
24. Current Use of Site*
26. Requested Improvements(s) or Use*
28. Request modifications to the following (check all that apply):*

    1. Front Yard Setback Distance
    2. Side Yard Setback Distance
    3. Rear Yard Setback Distance

    1. Natural Resource Protection Area
    2. Size [Accessory Building]
    3. Height [Signage]

    1. Width [Signage]
    2. Size [Signage]
    3. Director's Interpretation
30. Complete this Section if a Setback or Size Variance is Being Requested:
32. Requested Front Yard Setback
33. Requested Side Yard Setback
34. Requested Rear Yard Setback
35. Requested Size of Accessory Building (in square feet)
37. Requested Height of Signage
38. Requested Width of Signage
39. Requested Size of Signage (in square feet)
41. Rationales for Request (Complete for All Requests)
43. Document Upload
    Detailed plans are required, at a size no larger than 11"x17" and to scale, depicting property lines, setback lines, location and dimensions of all existing and proposed improvement(s), and adjacent roadways labeled.
45. Plot/Site Plan*
    Choose File
47. Construction/Architectural Drawings*
    Choose File
49. Variance Request Explanation [if further details are needed to above rationales]
51. Letters from property owners, surrounding subject site [optional, yet highly encouraged]
53. Trustee/Association Approval Letter [optional, but may be a condition if variance is approved by Board]
55. Trustee/Association Prohibition*

    Do any deed restrictions or indenture prohibit the use or construction of the improvement(s) being requested by this petition, if the variance is granted?

    1. Yes
    2. No
57. Trustee/Association Notification*

    If you answered yes above, have you contacted the trustee/association regarding your request?

    1. Yes
    2. No
59. Confirmation:*

    1. By checking this box, I verify the accuracy of this information and I have the right to make this request for the subject property. I also acknowledge payment of the $250 fee, upon receipt of invoice.
Leave This Blank:


61. 1. Receive an email copy of this form.
62. Email address

    This field is not part of the form submission.

63. Submit

* indicates a required field