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CITY OF NORTH HIGH SHOALS REZONE & CONDITIONAL USE PERMIT APPLICATION Requested Action: Rezoning from: to Conditional Use Permit: for: Use Current Use: Proposed Use: Property Location: (Physical Description) Tax Parcel Number: Size (Acres): Current Zoning: Future Development Map—Character Area Designation: Applicant is (check one): the Property Owner Not the Property Owner (attach Property Owner’s Authorization) Applicant’s Certification: I hereby certify that the information contained in and attached to this application is true and correct. Signature: Date: Notarized: Property Owner Name: Address: Telephone: (No P.O. Boxes) Applicant Name: Address: Telephone: (No P.O. Boxes) Narrative (Detailed Description of the Request) Concept Plan Attachments to the Concept Plan: Pre-approved Sanitary Sewer Extension Submittal Representative Architecture/Photographs Proof all property taxes paid in full Other Attachments: Attachments (check all that apply) Property Owner’s Authorization (if applicable) Application Fee Warranty Deed Typed Legal Description Plat of Survey Disclosures (Interest & Campaign Contributions) Zoning Impact Analysis Version 05/20/2020 SIGN