Fill - Free fillable APPEAL OF ADMINISTRATIVE DECISION APPLICATION (Deerfield Beach, FL) PDF form

Phone: 954-480-4206 Appeal Application Fax: 954-422-5816

APPEAL OF ADMINISTRATIVE DECISION

APPLICATION

Instructions: Fully complete all sections of the application form

(type or print-must be legible)

Application Sections

1. Appellant information.

2. Demonstration of compliance with appeal criteria.

Be sure to attach the following:

1. Letter of authorization-if person(s) other than the appellant will be representing

the case at the public hearing.

2. $300 Application Processing Fee.

3. Proof of ownership from the property owner. If ownership cannot be verified

through the Broward County Tax Roll, a copy of the recorded Warranty Deed, a

copy of a valid purchase contract, or a signed and notarized letter from the owner

of record must be submitted with this application.

Submit to:

City of Deerfield Beach

Planning & Zoning Division

150 NE 2

nd

Ave.

Deerfield Beach, FL 33441

Case No._________

Date____________

Page 2 of 8

Phone: 954-480-4206 Appeal Application Fax: 954-422-5816

APPEAL OF ADMINISTRATIVE DECISION APPLICATION

PLEASE PROVIDE IN FULL THE FOLLOWING INFORMATION (PRINT OR TYPE)

Section One: Appellant Information

Name of Appellant: ____________________________________________________________

Signature: ___________________________________________________________________

Relationship of Appellant to Property (property interest of appellant): _____________________

Street Address: _______________________________________________________________

City, State, Zip: _______________________________________________________________

Phone Number: _______________________________________________________________

E-mail Address: _______________________________________________________________

Fax Number: _________________________________________________________________

Subject Property Address: _______________________________________________________

(if different from appellant’s address)

Property Owner Name: _________________________________________________________

Property Owner Signature: ______________________________________________________

Section Two: Demonstration of Compliance with Appeal Criteria

(Attach additional page(s) if more space is needed)

APPEAL FROM DECISION OF ADMINISTRATIVE OFFICIAL ON LAND

DEVELOPMENT CODE

INTERPRETATION –SECTION 98-116

Appeals. Any person aggrieved or any officer, board or commission of the City of

Deerfield Beach affected by any decision of the director, or any other administrative

official under any provision of this code may appeal such decision to the special master.

Every appeal shall be in writing and in the form and manner provided by this Code.

The application will not be accepted without a specific statement in response to

each of the requirements on the following pages.

Case No._________

Date____________

Page 3 of 8

Phone: 954-480-4206 Appeal Application Fax: 954-422-5816

1. PLEASE STATE THE ORDER, REQUIREMENT, DECISION OR DETERMINATION

(DECISION) YOU WISH TO APPEAL (DESCRIBE THE DECISION IN DETAIL

SUFFICIENT FOR THE CITY TO UNDERSTAND THE APPEAL).

_________________________________________________________________________________________________________

________________________________________________________________________________________________________

_________________________________________________________________________________________________________

Case No._________

Date____________

Page 4 of 8

Phone: 954-480-4206 Appeal Application Fax: 954-422-5816

2. WHO RENDERERD THE DECISION AND WHAT DATE WAS IT RENDERED?

_________________________________________________________________________________________________________

________________________________________________________________________________________________________

_________________________________________________________________________________________________________

Case No._________

Date____________

Page 5 of 8

Phone: 954-480-4206 Appeal Application Fax: 954-422-5816

3. DESCRIBE THE PROPERTY IN QUESTION.

________________________________________________________________________________________________________

_________________________________________________________________________________________________________

________________________________________________________________________________________________________

_________________________________________________________________________________________________________

Case No._________

Date____________

Page 6 of 8

Phone: 954-480-4206 Appeal Application Fax: 954-422-5816

4. IF THE DECISION IS CONTAINED IN A DOCUMENT OR EMAIL, PLEASE

ATTACH.

________________________________________________________________________________________________________

_________________________________________________________________________________________________________

________________________________________________________________________________________________________

_________________________________________________________________________________________________________

Case No._________

Date____________

Page 7 of 8

Phone: 954-480-4206 Appeal Application Fax: 954-422-5816

5. PLEASE STATE THE BASIS FOR THE APPEAL, INCLUDING WHY YOU THINK IT

IS INCORRECT AND SET FORTH ANY FACTUAL OR LEGAL SUPPORT FOR

YOUR CONTENTION. ALL ARGUMENT IN SUPPORT OF THE APPEAL SHOULD

BE SET FORTH HERE (YOU MAY ATTACH SEPARATE PAGES). NO

ARGUMENT OR THEORIES RELATIVE TO THE APPEAL SHALL BE PERMITTED

EXCEPT THOSE SET FORTH IN THIS APPEAL.

________________________________________________________________________________________________________

_________________________________________________________________________________________________________

________________________________________________________________________________________________________

_________________________________________________________________________________________________________

Case No._________

Date____________

Page 8 of 8

Phone: 954-480-4206 Appeal Application Fax: 954-422-5816

6. ATTACH ALL DOCUMENTS RELEVANT TO YOUR APPEAL OR YOUR

ARGUMENT IN SUPPORT OF THE APPEAL. PLEASE LIST ATTACHMENTS

BELOW.

________________________________________________________________________________________________________

_________________________________________________________________________________________________________

________________________________________________________________________________________________________

_________________________________________________________________________________________________________

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