D. REZONING REQUEST
Area to be rezoned: ____________ acres.
Rezoning includes ____ all, or ____ part, of the Parcel Number listed above.
* If only part of said parcel is to be rezoned, a lot split including a new survey will be required.
Zoning Request FROM ________ Zoning District [the current zoning] TO ________ Zoning District [the proposed zoning]
Frontage of the rezoning parcel: ________ feet. Depth of the rezoning parcel ________ feet.
Proposed use of the parcel and reason for the rezoning request:
E. ITEMS TO BE SUBMITTED WITH COMPLETED APPLICATION FORM
LEGAL DESCRIPTION: As required, submit a surveyor’s written legal description of the area to be rezoned.
SITE MAP: A Site Map identifying the property to be rezoned must be submitted. Note the location of existing structures
with distances from lot lines and/or proposed zoning boundaries. Show existing and/or proposed access point(s) to a public
road. Also show existing natural features of the site (such as creeks, ponds, drainage features, high and low spots) as well as
any known easements.
FILING FEE: A fee of $200, which is non-refundable, must be paid before a Rezoning Application can be accepted. Make
checks payable to “Clark County Community and Economic Development”. Said application will not be accepted as officially
filed, or be considered for processing, unless or until the appropriate forms have been completed, all information
(attachments/exhibits) have been submitted, and all fees have been paid in full.
F. PROPOSED DEVELOPMENT It is highly recommended that a preliminary plan and written narrative be submitted with
the rezoning application showing what development is being proposed.
G. PROPERTY OWNER/AGENT CERTIFICATION
I / We,
being duly sworn certify and say that the foregoing statements in this application and information included
in the attachments and exhibits, are true and correct to the best of my/our knowledge and belief. And
I/We certify that no legal action has been entered into or is pending that would be affected by any change
resulting from approval of this request. If the Applicant is not the Property Owner, I/We certify and say
that the Property Owner is aware of this Application and concurs with its submission.
SIGNATURE: ____________________________________________ DATE: _____ / _____ / __________
