Date Received:
Exchange of Property / Combination of Lots
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):
MPN Project Number:
Application Taken by:
Please Print or Type (all entities listed below will be copied on all comments)
1.
Applicant Name:
Email Address: Daytime Phone Number:
Business (if applicable):
Address: City: State: ZIP:
2.
Developer (if applicable): ________________________________________________________
Email address: ________________________________________________________________
3.
Name of Property Owner:
Email Address: Daytime Phone Number:
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.
Specific proposed use:
6.
Zoning District and Comprehensive Plan Land Use Designation:
7.
Size of property:
8.
Number of lots:
9.
Average size of lots:
10.
Type of request: Exchange of Property Combination of Lots
Applicant’s Initials
P a g e | 1 Oct 2019
11.
Acknowledgement:
I acknowledge that private deed restrictions or covenants may exist on the subject property. I
recognize that neither the Planning Commission nor its staff may consider such deed
restrictions or covenants, if any, when determining approval or denial of an application, nor
can the City or Parish enforce private deed restrictions or covenants. It is my responsibility as
an Applicant to determine if any such deed restrictions and covenants exist on the subject
property, and to be aware that violations of the same subject me and/or Property Owner to
litigation from others.
I understand that the application fee is nonrefundable. (Applications must be received by
10:00a.m. on the scheduled Application Deadline.)
Application must be signed by both applicant and property owner if different. Letter of
authorization must be submitted in absence of the property owner’s signature or where an
authorized agent signs in lieu of either property owner or applicant.
Signature of Applicant Type or Print Name of Applicant Date
Signature of Property Owner Type or Print Name of Property Owner Date
P a g e | 2 Oct 2019
click to sign
signature
click to edit
Staff Use Only
A.
Land Use Classification(s):
B.
Zoning Classification(s):
C.
Existing Land Use(s):
D.
Surrounding Land Use(s):
E.
Surrounding Land Use Classification(s):
F.
Surrounding Zoning Classification(s):
G.
Proposed Land Use:
H.
Comprehensive Plan: Consistent Not Consistent
I.
Planning District/Sub Area:
J.
Census Tract:
K.
Lot and Block:
L. Council District: 1 2 3 4 5 6 7 8 9 10 11 12
M.
Stormwater Management Plan (SMP):
No Yes If “No” explain:
N.
Complete Check List: No Yes
O.
Comments:
P.
Is subject property located on MoveBR? If so, contact as needed.
No Yes date correspondence sent:
Q.
Planning Director or Authorized Signature Date
P a g e | 3 Oct 2019