Danville-Boyle County Planning & Zoning Commission

445 West Main Street P.O. Box 670

Danville, Kentucky 40423

APPLICATION FOR ADMINISTRATIVE APPEAL

BOARD OF ADJUSTMENTS

Date of Hearing: Typically filled by government staff

Date of Submission: *

APPELLANT(S) INFORMATION

Primary Appellant First Name: *

Primary Appellant Last Name: *

Additional Appellants (Optional):

Add each additional appellant individually. Click "Add Another Appellant" to add more.

PROPERTY OWNER(S) OR BUSINESS ENTITY

Primary Owner First Name: *

Primary Owner Last Name: *

Additional Property Owners (Optional):

Please list names of all owners, directors and/or shareholders. Click "Add Another Owner" to add more.

ADDRESS INFORMATION

Street Address: *

City: *

State: *

ZIP Code: *

APPEAL DETAILS

Location of Property: *

Decision of Official from Which Appeal is Made: *

Provisions of Zoning Ordinance in Relation to Appeal: *

ADJACENT PROPERTY OWNER (OPTIONAL)

Street Address:

City:

State:

ZIP Code:

I hereby certify that the information provided in this application is true and correct to the best of my knowledge.

Appellant Signature (Type full name to acknowledge): *