P a g e | 1 October 2019
Date Received: ______________
Demolition or Relocation of a Historic Building
In the Downtown Character Area
City of Baton Rouge / Parish of East Baton Rouge
Office of the Planning Commission, 1100 Laurel Street, Suite 104
Baton Rouge, Louisiana 70802
Staff Use Only
Fee(s): ___________________ Application Taken by: ___________
Case Number: _________________ Meeting Date: _________________
MPN Project Number: _______________
Please Print or Type (all entities listed below will be copied on all comments)
1. Applicant Name and Title: _____________________________________________________
Email Address: __________________________ Daytime Telephone: ___________________
Address: ________________________ City: ___________ State: _________ ZIP: _________
Business (if applicable): _______________________________________________________
2. Developer (if applicable): ______________________________________________________
Email Address: ______________________________________________________________
3. Name of Property Owner: _____________________________________________________
Email Address: _________________________ Daytime Telephone: ____________________
Address: ________________________ City: ___________ State: _________ ZIP: _________
4. Subject Property Information:
CPPC Lot ID#(s): _____________________________________________________________
Lot #(s): ____________________________ Block/Square: ___________________________
Subdivision or Tract Name: ____________________________________________________
(If property is not subdivided, attach a complete legal description and a survey map
indicating bearings and dimensions.)
Nearest Intersection: _________________________________________________________
5. Property Street Address: ______________________________________________________
6. Specific Proposed Use: ________________________________________________________
7. Action Required: ☐ Demolition ☐ Relocation
Description:
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
Current Address: _____________________________________________________________
Proposed Address: ___________________________________________________________