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_____ Applicant’s Initials P a g e | 1 October 2019
Date Received: ______________
Waiver
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: _______________________________________________________________
Email Address: ____________________________ Daytime Telephone: ___________________
Address: ____________________________ City: _____________ State: _____ ZIP: _________
Business (if applicable): _________________________________________________________
2. Developer (if applicable): ___________________________________________________________
Email Address: ___________________________________________________________________
3. Name of Property Owner: _______________________________________________________
Email Address: ___________________________ Daytime Telephone: ____________________
Address: ____________________________ City: _____________ State: _____ ZIP: _________
4. 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: ___________________________________________________________
5. Specific Proposed Use (type of development and general background): ___________________
_____________________________________________________________________________
6. Waiver(s) type: ☐ Sidewalk ☐ Sidewalk Location ☐ Alternative Parking
Specify the ordinance section and paragraph, and give justification for the requested waiver(s):
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
7. Compliance with Development Review Committee and/or Departments of Development and
Transportation and Drainage comments will be required prior to approval:
☐ Acknowledgment ____________________________________________________________