APPLICATION                        Georgetown-Scott County Planning Commission

Project Name
Type of Application
Date App. Complete Required Fee Date Fee Paid

Contact:

Owner:
address: address:
phone: phone:
email: email:
Consultant:
firm:
address:
phone:
email:

Project Description (type project, # units or sq. ft., acres):
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________

Project Location: _____________________________________________________________________________________________

Utility Providers:                                                                           Other Reviewers:
(check all that apply)                                                                     (to be filled out by P & Z)

_______ A T & T _______ Health Department
_______ Georgetown Municipal Water and Sewer _______ KYTC District #7
_______ Kentucky American Water _______ Soil Conservation
_______ Kentucky Utilities _______ City Fire Dept.
_______ Owen Electric (Owen County RECC) _______ County Fire Dept.
_______ Bluegrass Energy (Harrison County RECC) _______ City Road Dept.
_______ Columbia Gas _______ County Road Dept.
_______ Stamping Ground Water and Sewer _______ City Engineer
_______ Delaplain Disposal _______ City Police
  _______ Emergency Management Services
  _______ Time Warner Cable
  _______  Building Inspection

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