Rev 12/2017
City of Manchester
14318 Manchester Road
Manchester, MO 63011
P: (636) 227-1385 ex. 118
F: (636) 821-8099
pandz@manchestermo.gov
Applicant:____________________________________________________________________________________
Address:__________________________________________ Phone:______________________________
City, State, Zip:_____________________________________ Email:______________________________
Where the division of land involving the sale or transfer of parcels of land to or between adjoining property
owners and where such sale or transfer does not create an additional lot nor reduce the original lot or lots
below the requirements of the applicable zoning district or districts, a Boundary Adjustment Plat shall be
submitted to and approved by the City. Application Fee: $300
Lot 1 Information:
I hereby certify that the information contained in this application and accompanying documents are correct, and that I
will conform to all applicable laws of the City of Manchester.
Applicant Signature:______________________________________________________Date:___________________
Applicant’s Name Printed:_________________________________________________________________________
Zoning Fees Fee paid on:______________________ Amount:_____________________
ZONING APPROVAL City of Manchester Permit #:____________________
Received by:______________________________________________________Date:________________________
Director, Planning, Zoning and Economic Development
FOR OFFICE USE ONLY BELOW
Boundary
Adjustment
Application
Zoning:____________________ Lot Size:____________________
Lot Address:___________________________________________________________________________________
Owner (Print):__________________________________________________________________________________
Owner Signature:_______________________________________________________________________________
Telephone:_____________________________________Email:__________________________________________
Address:______________________________________________________________________________________
Legal Interest ______________________________, If not owner of record, attach signed, notarized statement from
owner as to petitioner’s authority to act on his/her/their behalf in connection with this petition. Owner of Lot as Shown
on Deed (If different from applicant.)
Lot 2 Information:
Zoning:____________________ Lot Size:____________________
Lot Address:___________________________________________________________________________________
Owner (Print):__________________________________________________________________________________
Owner Signature:_______________________________________________________________________________
Telephone:_____________________________________Email:__________________________________________
Address:______________________________________________________________________________________
Legal Interest ______________________________, If not owner of record, attach signed, notarized statement from
owner as to petitioner’s authority to act on his/her/their behalf in connection with this petition. Owner of Lot as Shown
on Deed (If different from applicant.)