TITTABAWASSEE TOWNSHIP

APPLICATION FOR SPECIAL USE PERMIT

(Must Be Submitted At Least Forty Five (45) Days Prior To Meeting)

Completed Application must include all fees, a site plan application along with 10 full size copies and 1 reduced copy of site plan.

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Applicant:                                                                            Date: _____________________________

Address:_______________________________________ _________________________________

Telephone: (      )                                                       Fax: (          )                                                          

Applicants Signature:________________________________________________________________

Owner (If different than applicant):_____________________________________________________

Address:                                                      Telephone (        )                        Fax (      )                       

Owner's Signature_____________________________________________________________________

Subject Property Address:                                                                                                                            

Legal Description (Provide the legal description of the property affected - if additional space is needed please attach on a separate sheet to this application):

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Proposed Use(s):     _______________________________________________________________

For Office Use Only:

Date Filed                                                 Amount Paid:                                    Case #: ________________________

Hearing Date: Current Zoning:  ______________________________________________________________

Parcel Identification Number: ________________________________________________________________

 

Revised 03/22/02