____ Applicants Initials P a g e | 1 October 2019
Date Received ______________
Rezoning
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 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: _____________
Business (if applicable): _______________________________________________________
Address: ___________________________ City: _____________ State: ______ ZIP: _______
4. Property Information:
CPPC Lot ID#(s): _____________________________________________________________
Lot #(s): ____________________________________ Block/Square: ___________________
Subdivision or Tract Name: ____________________________________________________
Area to be Rezoned:
☐Standard ☐Single Metes and Bounds ☐Multiple Metes and Bounds
5. Property Street Address: ______________________________________________________
6. Specific Proposed Use: ________________________________________________________
7. Action Requested:
☐ Rezoning To rezone from ______________to ______________
Acres: ______________________________________
8. Justification for action requested: _______________________________________________
___________________________________________________________________________