Fillable ANX Annexation Application (City of Rockville)

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ANX Annexation Application (City of Rockville)

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The ANX Annexation Application (City of Rockville) form is 2 pages long and contains:

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  • 4 check-boxes
  • 18 other fields

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File type: PDF

U.S.A. forms for City of Rockville

BROWSE CITY OF ROCKVILLE (MD) FORMS

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Application for
Annexation Application
City of Rockville
Department of Community Planning and Development Services
111 Maryland Avenue, Rockville, Maryland 20850
Phone: 240-314-8200 • Fax: 240-314-8210 • E-mail: Cpds@rockvillemd.gov • Web site: www.rockvillemd.gov
Please Print Clearly or Type
Property Address Information ___________________________________________________________________________
Subdivision _________________________ Lot (S) _________________________ Block __________________________
Zoning ____________________________ Tax Account (S) ________________ , ______________ , __________________
Property Size (in square feet) ___________________________________________________________________________
Property’s Use Existing (to include office, industrial, residential, commercial) _______________________________________
Applicant Information:
Please supply Name, Address, Phone Number and E-mail Address
Applicant __________________________________________________________________________________________
__________________________________________________________________________________________________
Property Owner ______________________________________________________________________________________
__________________________________________________________________________________________________
Architect ___________________________________________________________________________________________
__________________________________________________________________________________________________
Engineer ___________________________________________________________________________________________
__________________________________________________________________________________________________
Attorney ___________________________________________________________________________________________
__________________________________________________________________________________________________
Property Current Zoning In Montgomery County _____________________________________________________________
ANX
2/09
STAFF USE ONLY
Application Acceptance: Application Intake:
Application # _________________________________ OR Date Received _______________________________
Date Accepted ________________________________ Reviewed by ________________________________
Staff Contact _________________________________ Date of Checklist Review _______________________
Deemed Complete: Yes o No o
Print Form
ANX Page 2
2/09
Project Name _______________________________________________________________________________________
Metes and Bonds Description ___________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
A letter of authorization from the owner must be submitted if this application is filed by anyone other than the owner.
I hereby certify that I have the authority to make this application, that the application is complete and correct and that I have
read and understood all procedures for filing this application.
Please sign here _____________________________________________________________________________________
Application Checklist:
The following documents are to be furnished as part of this application:
Submitted
o Complete Application
o Filing Fee
o Petition
o Metes and Bonds description and graphic plan prepared and certified by a professional engineer.
Twelve (12) copies: (size 8.5 x 11, 11x14, or 11x17)
• Electronic Copy
Comments on Submittal: (For Staff Use Only)
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
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ANX Annexation Application (City of Rockville)

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Completed 16 July 2020

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