Appendix 1A. APPLICATION FOR REZONING

City of Bessemer

Application for Rezoning

Planning & Zoning Commission

Date: ____________

Name of Applicant: ____________ Phone: ____________

Address ____________ City ____________ State ____________ Zip Code ____________

Owner of Property: ____________ Phone: ____________

Address ____________ City ____________ State ____________ Zip Code ____________

Legal Description of Property: Map Book: ____________ Page: ____________ / ____________ / ____________

Address of Property: ____________ City ____________ State ____________ Zip Code ____________

Parcel Identification Number: ____________

Zone Requested: ____________

Present Use: ____________

Scheduled for Hearing: ____________

Zone Requested: ____________

Proposed Use: ____________

Reason for Rezoning Request: ____________

□ Attached Tax Map of Property Showing Zoning & Zoning of Adjacent Property.

□ Attached Copy of Ownership Deed.

□ Attached Preliminary Site Plan.

□ Attached Additional Pages as Necessary.

____________ ____________
Applicant Signature

____________ ____________
Disposition