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Land Use & Development Application Planning Services 3330 South 1300 East • Millcreek, Utah 84106 Phone: (801) 214-2750 Millcreek.us File # Community Council:_ Parent File Property Address:_ Parcel Name of Property Acreage:_ Please describe your request: New Development: q Conditional Use q Permitted Use q Subdivision # lots: q PUD #lots: Modify an Existing Development: q Change Conditions of Approval q Change the Site Plan q Condo Conversion q Lot Consolidation q Lot Line Adjustment q Mobile Store q Signs q Billboards Other: q Exception Request q General Plan Amendment q GRAMA (Records Request) q Land Use Hearing q Non-Conforming q RCOZ Appeal (Option C) q Research Request q Re-zone q Right-of-Way Improvement Permit q Vacate a Street Is a key or gate code required to access the property? q Yes q No If yes, (or provide driving directions to property): Revised 22 May 2018 (1 of 2) ---PAGE BREAK--- APPLICANT’S NAME: First:_ Last:_ Initial:_______ Address:_ City:_ To facilitate the land use notice and review process, the undersigned hereby authorize the City to reproduce this application and all documents attached to the application for staff, officials, and the interested public: Applicant’s Signature:_ Property Owner(s): First:_ Last:_ Initial:_______ Address:_ City:_ Professional(s): q Engineer q Architect q Other Address:_ City:_ Revised 22 May 2018 (2 of 2) *NOTE: all correspondence will be sent to the applicant’s address: SIGN