REZONING APPLICATION         Georgetown-Scott County Planning Commission

Name of Applicant:
Project Name:
Date Filed: Fee:

Property Information

Address ( Street Number and Name):
Approximate Size of Tract:    _______ acres    ______ sq. ft.
Sanitary Sewer Available:  ____ yes     ____ no Existing Land Use (Ag., SF Res. etc.):

Requested Rezoning:   From  _________  To: __________

Project Description (type, #of units, etc.): 
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All correspondence relating to this application should be mailed to: 

Contact Person
Address:
 
 
Phone: Fax:
email:  
Engineer/Reg. Land Surveyor/Consultant:
Address:
 
Phone: Fax:
email:  

Owner(s) Information (Names of all property owners involved must be listed below):

Name: Address: City/State: Phone:
Name: Address: City/State: Phone:
Name: Address: City/State: Phone:

AUTHORIZATION OF APPLICATION:
I hereby certify that I am the authorized applicant or owner, representing ALL property owners involved in this request or holders of option on same, as listed above.

Name (print): ____________________________   Signature: _____________________________
Address (if different than previously listed):  __________________________________________

 

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

 

Please state the legal justification for the requested zone change (reference the adopted Comprehensive Plan/Land Use Plan, Zoning Ordinance, availability of utilities, etc.):

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