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((
APPLICATION IS DUE TWO (2) WEEKS PRIOR TO MEETING
APPLICATION FOR ZONING AMENDMENT
CITY OF TROY PLANNING COMMISSION
(MUST BE TYPED OR PRINTED LEGIBLY IN BLACK INK)
(READ SECTION 1139 OF THE ZONING CODE BEFORE COMPLETING APPLICATION)
An application for an amendment to the City of Troy, Ohio Zoning Code that would change the zoning classification for
the property located at _______________________________________________________________
(Street Address)
being lot number(s) ________________________ from _______________________ to ______________________.
(Parcel Identification Number) (Existing Zoning Classification) (Proposed Zoning Classification)
(Proposed Zoning Classification)
OWNER
APPLICANT
Name
Name
Address
Address
City
City
State
State
Zip Code
Zip Code
Phone No.
Phone No.
Fax No.
Fax No.
Email
Email
The applicant is the _______________________________________ of the property, which is subject to this application.
(State the interest of the applicant)
PLEASE PROVIDE THE FOLLOWING:
1. The reasons for seeking a change in the zoning classification or zoning text: Attach as EXHIBIT "A".
2. The legal description of the land proposed to be reclassified: Attach as EXHIBIT "B".
3. A site plan prepared by a registered engineer, surveyor or architect in duplicate drawn to such scale as to clearly
show:
a. The actual dimensions of the subject property according to the recorded plat of such property, lot
numbers, it’s present zoning classification, existing and proposed uses: Attach as EXHIBIT “C”.
b. The present zoning classification of all surrounding lands located within two hundred and fifty (250) feet
of the land proposed to be reclassified: Attach as EXHIBIT "D".
c. A list (see example) of the names, addresses, and lot numbers of the owners of property within a radius
of two hundred and fifty (250) feet from the parcel or parcels of land proposed to be reclassified:
Attach as EXHIBIT "E"
i. Include one (1) copy of County Tax Maps
ii. Include two (2) sets of mailing labels
4. 2 complete sets (Exhibits A-E) reproducible in a format no larger than 11”x17”
5. Filing Fee of $150.00 made payable to the City of Troy
Scheduled Planning Commission Meeting
(Held every 2
nd
and 4
th
Wednesday of the month at 3:30 p.m.)
Date Requested: _________________
Applicant(s) scheduled on the agenda will be notified
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I HEREBY DEPOSE AND SAY THAT THE ABOVE STATEMENTS AND THE STATEMENTS CONTAINED IN ALL
THE EXHIBITS PREPARED BY ME AND TRANSMITTED HEREWITH ARE TRUE.
____________________________________________
(Applicant Signature)
Subscribed and sworn to before me this ________day of ________________, 20____
My Commission Expires _____________________________________
(Month/Date/Year)
____________________________________________
(Notary Public)
(For Office Use Only - Do Not Write Below This Line)
REQUIRED DOCUMENTS:
EXHIBIT A
Reasons for Zoning Reclassification
EXHIBIT B
Legal Description
EXHIBIT C
Site Plan: lot dimensions, lot numbers, current zoning, existing and proposed uses
EXHIBIT D
Site Map with Zoning & Owners within 250 feet of parcel
EXHIBIT E
Property Owners List within 250 feet of parcel
Labels
Two (2) Sets of Mailing Labels of Property Owners
Copies
(1) Complete Sets in a reproducible format 11”x17”
Map(s)
One (1) County Tax Map(s)
Filing Fee Check issued to City of Troy for $150.00
(15) Complete Sets in a reproducible format 11”x17”
Additional Documentation (List):
PLANNING COMMISSION DISPOSITION:
PUBLIC HEARING DATE
RECOMMENDATION TO CITY COUNCIL
CITY COUNCIL DISPOSITION:
1
st
Reading: 2
nd
: 3
rd
:
PUBLIC HEARING DATE
COUNCIL COMMITTEE RECOMMENDATION
Approved: Denied:
CITY COUNCIL ACTION
Ordinance Number:
Effective Date:
Revised 10/25/11
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