Fillable Jackson Twp Zoning Hearing Board Application

Fill Online, Printable, Fillable, Blank Jackson Twp Zoning Hearing Board Application Form

Use Fill to complete blank online JACKSON TOWNSHIP (PA) pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

Jackson Twp Zoning Hearing Board Application

On average this form takes 24 minutes to complete

The Jackson Twp Zoning Hearing Board Application form is 3 pages long and contains:

  • 2 signatures
  • 10 check-boxes
  • 83 other fields

Country of origin: US
File type: PDF

U.S.A. forms for Jackson Township

BROWSE JACKSON TOWNSHIP (PA) FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
Site Address: Tax Parcel #:
Lot #: Subdivision / Land Development:
Owner: Phone #: Fax #:
Mailing Address: Email:
Applicant: Phone #: Fax #:
Mailing Address: Email:
Phone #: Fax #:
Mailing Address: Phone #: Fax #:
Type of Request (Check All That Apply)
Appeal Special Exception Challenge Variance Conditional Use
Easement
Change of Use Other
Descripe, in detail, the exception being sought with this appeal application:
Grounds for Appeal, including hardship if requesting a variance:
Page 1 of 3
Date Received:
Zoning District:
Zoning Permit #:
Jackson Township, Luzerne County, PA
Zoning Hearing Board Application
2211 Huntsville Rd.
Shavertown, PA 18708
Phone: 570-675-8371 Extension # 3 Fax: 570-675-1590
Residential
Non-Residential
Attorney:
*** Fill out ONLY applicable blocks. If unknown, leave blank.
Please Name And Describe All Properties Within A 200 Foot Radius Of The Property Applying For The Variance:
*** Use a separate sheet for additional properties, if needed.
Address:
Address:
Address:
Address:
Address:
Address:
Address:
Address:
Address:
Address:
No Application Is Considered A Complete Submission Without The Correct Fees Being Paid In Full.
Fees Associated With This Application Are NON-REFUNDABLE.
Applicant Printed Name:
Applicant Signature: Date:
Page 2 of 3
Parcel ID #:
Parcel ID #:
Parcel ID #:
Parcel ID #:
Parcel ID #:
Parcel ID #:
Parcel ID #:
I certify that the code administrator or the code administrator's authorized representative shall have the authority
to enter areas covered by such permit at any reasonable hour to enforce the provisions of the code(s) applicable
to such permit.
Parcel ID #:
The applicant certifies that all information on this application is correct and accurate. The property owner and applicant
assumes the responsibility of locating all property lines, seback lines, easements, rights-of-way, flood areas, etc.
Issuance of a permit and approval of construction documents shall not be construed as authority to violate,
cancel or set aside any provisions of the codes or ordinances of the Municipality or any other governing body.
The applicant certifies he/she understands all the applicable codes, ordinances and regulations.
Parcel ID #:
Parcel ID #:
click to sign
signature
click to edit
Jackson Township Official Use Only
Processing Record
Application
Application Date: Date:
Date Received as a Complete Submission: Date:
Public Notices
1st Publication (30 Days Max. from meeting date) Date:
2nd Publication (7 Days Max. from meeting date) Date:
Property Posted (7 Days Max. from meeting date) Date:
Hearings
Initial (60 Days Max. from Application) Date:
Subsequent (45 Days Max. from meeting date) Date:
Subsequent (45 Days Max. from meeting date) Date:
Subsequent (45 Days Max. from meeting date) Date:
Applicant's Required Completion
Final Presentation (100 days Max. from the First Hearing) Date:
Decision / Conclusion
Written Notice From The Board Date:
Additional Notes:
Zoning Officer's Signature: Date:
Page 3 of 3
click to sign
signature
click to edit
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

Jackson Twp Zoning Hearing Board Application

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 13 July 2020

Message

View Audit Log
Print With Audit Log
Duplicate Document