4. Address1
6. Address2
8. City
9. State
10. Zip
12. Phone
14. The following change in the Town's Zoning District Classification is hereby requested
    State Existing and Proposed Zoning
16. For the Construction, Improvement, Alteration, Location, or Use of
18. At the Following Location
    Provide Exact Legal Description

20. In accordance with the requirements of the Town's Zoning Ordinances and State Law, the names and addresses of all property owners within a three hundred foot radius of the exterior boundary of the property described above, have been provided on a sheet attached to this application (A current list from the County Tax assessors' office or a bonded abstract company).

    
    

    A deposit of $375 is required at the time of application. Two Hundred $200 of this is an application fee. The balance of the fee is used for certified mailing and legal publications. Any amount in excess will be refunded after final publication billings are received.

    
    

    Plans and drawings for the proposal are attached indicating compliance with setback, parking, and other requirements of the requested Zoning District.

22. Signed
    By typing your name into this field you authorize the Town of Goldsby to consider this an electronic signature.
23. Date
    Date
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30. 1. Receive an email copy of this form.
31. Email address

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32. Submit

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