Narrative (Limit 1400 Characters, use separate sheet if needed):
Please write a short narrative of the request including your reason for seeking an administrative
I, the undersigned, do hereby certify that all of the information presented in this application is
accurate to the best of my knowledge, information, and belief.
Further, I hereby authorize county officials to enter my property during reasonable business hours
for purposes of determining zoning compliance. All information submitted and required as part of
this application process shall become public record.
*Note: Forms must be signed by the owner(s) of record, contract purchaser(s), or other person(s)
having a recognized property interest. If there are multiple property owners/applicants, a
signature is required for each.