____ Applicant’s Initials P a g e | 1 October 2019
Date Received: ______________
Site Plan
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. Type of application: ☐New ☐Revised (SP- - )
2. Applicant Name: _______________________________________________________________
Email Address: ____________________________ Daytime Telephone: ___________________
Address: ____________________________ City: _____________ State: _____ ZIP: _________
Business (if applicable): _________________________________________________________
3. Developer (if applicable): ________________________________________________________
Email Address: ________________________________________________________________
4. Name of Property Owner: _______________________________________________________
Email Address: ___________________________ Daytime Telephone: ____________________
Address: ____________________________ City: _____________ State: _____ ZIP: _________
5. 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 survey map indicating
bearings and dimensions.)
Nearest Intersection: ___________________________________________________________
6. Specific Proposed Use (type of development and general background): ___________________
_____________________________________________________________________________
_____________________________________________________________________________
7. Waiver(s) requested: ☐ No ☐ Yes
If “Yes,” specify the ordinance section and paragraph, and give justification for the requested
waiver(s): ____________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________