Mailing List Application Form
For Applications Requiring a Public Hearing in Sussex County
Please fill out this form and return it with your application. As a part of your application, a Public
Hearing is required. The property owners within 200’ of the site of the application will be notified.
Staff will notify the property owners.
Application Information:
Site Address:
Parcel #:
Site Address:
Parcel #:
Applicant Name:
Owner Name:
Type of Application:
Conditional Use:
Change of Zone:
Subdivision:
Board of Adjustment:
Date Submitted:
For office use only:
Date of Public Hearing: _______________
File #:_____________________
Date list created: _____________ List created by: ___________
Date letters mailed: ___________ Letters sent by: ___________