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___________________________________________________________________
APPLICATION FOR A VARIANCE
CITY OF TROY BOARD OF ZONING APPEALS
(MUST BE TYPED OR PRINTED LEGIBLY IN BLACK INK)
_________________________________________________________________________________________
(Street Address)
_________________________________________________________________________________________
(Parcel Identification Number) (Zoning District)
OWNER
APPLICANT
Name
Name
Address
Address
City
City
State
State
Zip Code
Zip Code
Phone No.
Phone No.
Fax No.
Fax No.
Email
Email
The applicant is the ____________________________________________ of the property, which is subject to this application.
(State the interest of the applicant)
( (OFFICE USE ONLY)
_____ EXHIBIT A
_____ EXHIBIT B
_____ EXHIBIT C
_____ EXHIBIT D
_____ EXHIBIT E
_____ Copies
_____ Labels
_____ Map(s)
_____ Filing Fee
Board of Zoning Appeals meetings are held every 2
nd
and 4
th
Tuesday of the month at 3:30 p.m. in the council chambers on
the second floor.
COMPLETED APPLICATIONS ARE DUE TWO (2) WEEKS
PRIOR TO MEETING. Applicant(s) will be notified if your
application is scheduled on the agenda.
Office Use only
Date Filed ___________________________
Accepted by _________________________
Filing Fee Pd. ________________________
Receipt # ____________________________
Date of Meeting ______________________
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PLEASE READ CAREFULLY AND ANSWER THE FOLLOWING ITEMS AS FULLY AS YOU CAN. USE SEPARATE
SHEET(S) IF NEEDED. READ ATTACHED SECTION 1137 OF THE ZONING CODE BEFORE COMPLETING
APPLICATION.
(A) The particular requirements of this Zoning Code which prevent the proposed use or construction.
(For example, Section 1142.08 (f) (5) Rear Yard Setback of 30’)
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(B) The characteristics of the subject property which prevent compliance with requirements of this Zoning Code.
_______________________________________________________________________________________
_______________________________________________________________________________________
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(C) The reduction of the minimum requirements of this Zoning Code which would be necessary to permit the proposed
use or construction (List all variances requested).
_______________________________________________________________________________________
_______________________________________________________________________________________
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(D) The particular hardship, which would result if, said particular requirements of this Zoning Code were
applied to the subject property (Unique conditions or physical impairments).
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
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I HEREBY DEPOSE AND SAY THAT THE ABOVE STATEMENTS AND THE STATEMENTS CONTAINED IN ALL THE
EXHIBITS PREPARED BY ME AND TRANSMITTED HEREWITH ARE TRUE.
____________________________________________
(Applicant Signature)
Subscribed and sworn to before me this ________day of ________________, 20____
My Commission Expires _____________________________________
(Month/Date/Year)
____________________________________________
(Notary Public)
(Office Use Only - Do Not Write Below This Line)
DISPOSITION OF BOARD OF ZONING APPEALS:
PUBLIC HEARING DATE
DATE OF DECISION
Approved: Denied:
DECISION OF THE BOARD
AMENDED / CONDITIONS ATTACHED
Revised 10/25/11
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