Application No. ________________
HENDERSON COUNTY
TEXT AMENDMENT APPLICATION FORM
GENERAL INFORMATION
Date of Application: ___________________________________
Previously Submitted (Circle One): Yes No
Date of Pre-Application Conference: _____________________
INFORMATION ABOUT THE PROPOSED TEXT AMENDMENT REQUEST
A. Will the proposed amendment(s):
1. Change one or more existing sections of the Land Development Code? ___Yes ___No
2. Add one or more new sections to the Land Development Code? ___Yes ___No
B. Number(s) and titles(s) of the section(s) proposed to be amended._____________________________________
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C. Proposed amendment which explains the purpose for the amendment.__________________________________
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D. Attached is a copy of the proposed text change(s): ___Yes ___No
CONTACT INFORMATION
Applicant:
Name: ____________________________ Phone: _________________________________________
Address: __________________________ City, State, and Zip: __________________________________
Agent:
Name: ____________________________ Phone: _________________________________________
Address: __________________________ City, State, and Zip: __________________________________
Agent Form (Circle One): Yes No
I certify that the information shown above is true and accurate and is in conformance with the Land Development
regulations of Henderson County.
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Print Applicant (Or Agent)
__________________________________ _________________
Signature Applicant (Or Agent) Date
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County Use Only
Fee: $_____________ Paid: _____________ Method: __________ Received by: _________________
