Page 2 of 2 The lot has frontage of _______ feet on one or more of the following: State Highway (name) ________________ Accepted Town Road (name) ________________ in a filed subdivision approved by the planning & zoning commission with a completion bond in effect._________
THERE ARE (#) ______ PROPOSED BUILDINGS ON THE LOT
List below any additional data and/or plan submitted with this application: ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ Approval of this application or issuance of a zoning permit shall not be considered to constitue compliance with any other regulations, ordinance or law or relieve the undersigned from responsibility to obtain permit thereunder. Date ______________ Applicant's name in print ___________________________ Applicant's Signature _________________________________________________ Approved______ Denied _______ If Denied, Reason(s) _________________________________________________ Date ______________ Signature ______________________________________ |