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TULLAHOMA MUNICIPAL REGIONAL PLANNING COMMISSION (City of Tullahoma)

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PO Box 807, 321 North Collins Street
,
Tullahoma, Tennessee 37388
SITE PLAN APPLICATION
Name of Site Plan
Date of Application
Site plans for parking lot additions with no new building construction can be reviewed and approved
administratively.
Applicant/ Developer
Mailing Address
City
State
Zip
Phone Number
Email
Project Engineer/Surveyor
Mailing Address
City
State
Zip
Phone Number
Fax Number
Email
The applicant is responsible for notifying the Planning & Codes Department if any contact information has changed.
1.
PLEASE COMPLETE THE FOLLOWING PROPERTY INFORMATION:
Address of Subject Property
Size of Property
Tax Map
Group
Parcel
Deed Book
Page Number
Zoning of Property
Zoning Application File Number (if applicable)
2.
ADDITIONAL REQUIRED INFORMATION:
A copy of the owner’s deed
Site plan checklist
A copy of Notice Of Intent (NOI) Form (if applicable)
NOTE: NOI and NPDES are required by the
state if more than 1 acre of land is to be
disturbed.
A copy of NPDES Permit (if applicable)
I hereby certify that the information contained in this application is true and correct to the best of my
knowledge and belief.
Applicant’s Signature
Applicant’s Name (Printed)
Date
STAFF USE ONLY - FEES
Site Plan Review
Fee
Accepted By
Receipt Number
Total
Number of Plans
$250.00
x __________
P: 931-455-2282 F: 931-454-1768 www.tullahomatn.gov
TULLAHOMA MUNICIPAL REGIONAL PLANNING COMMISSION
$250 FEE
Date
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TULLAHOMA MUNICIPAL REGIONAL PLANNING COMMISSION (City of Tullahoma)

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Completed 24 January 2021

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