Appendix 1D. APPLICATION FOR VARIANCE
City of Bessemer
Zoning Board of Adjustment
TELEPHONE ____________ DATE ____________
APPLICANT ____________ ADDRESS ____________
OWNER ____________ ADDRESS ____________
LOCATION OF PROPERTY ____________ ____________
(Street and Number/Subdivision and Lot Number)
Note— Fill in Section 1, 2, or 3 as appropriate. Do not fill in more than one of these sections. This application is not acceptable unless all required statements have been made. Additional information may be supplied on separate sheets if the space provided is inadequate.
Sec. 1. Appeal from decision of building official.
Relation to the enforcement of the Zoning Ordinance
Describe decision of the Building Official from which appeal is made: ____________
____________ ____________ ____________ ____________ / ____________ / ____________
____________ ____________ ____________ ____________ / ____________ / ____________
Provision of the Zoning Ordinance or district boundary in question: ____________
____________ ____________ ____________ ____________ / ____________ / ____________
Sec. 2. Application for an adjustment.
As required by the Zoning Ordinance
Provision of the Zoning Ordinance Requiring a Special Exception in this case: ____________
____________ ____________ ____________ ____________ / ____________ / ____________
____________ ____________ ____________ ____________ / ____________ / ____________
Description of proposed use showing justification for a Special Exception: ____________
____________ ____________ ____________ ____________ / ____________ / ____________
____________ ____________ ____________ ____________ / ____________ / ____________
Sec. 3. Application for an adjustment.
As required by the Zoning Ordinance
Provision of the Zoning Ordinance from which an adjustment is requested: ____________
____________ ____________ ____________ ____________ / ____________ / ____________
____________ ____________ ____________ ____________ / ____________ / ____________
Peculiar or unusual conditions which justify an adjustment is requested: ____________
____________ ____________ ____________ ____________ / ____________ / ____________
____________ ____________ ____________ ____________ / ____________ / ____________
STATUS
Building Permit Number ____________ Date ____________ Signed ____________ / ____________ / ____________
Date this Application Filed ____________
Notice of Hearing ____________
Advertised On ____________
Date of Hearing ____________
Notice Mailed To ____________
APPLICANT
DECISION
Granted
Application or appeal denied in accordance with terms of the following resolution:
____________ ____________ ____________ ____________ / ____________ / ____________
____________ ____________ ____________ ____________ / ____________ / ____________
Date ____________ ____________ / ____________ / ____________ ____________ ____________ ____________
Chairman, Zoning Board of Adjustment