File #: ___________

Planning & Zoning

Project Contact List

Applicant Information

Applicant Name: ________________________________________________________________

Applicant Address: ______________________________________________________________
City: ___________________________________ State: ____________ Zip: ______________
Phone #:_________________________ E-mail:________________________________________

Owner Information

Owner Name: __________________________________________________________________

Owner Address: ________________________________________________________________
City: ___________________________________ State: ____________ Zip: ______________
Phone #:__________________________ E-mail:_______________________________________

Engineer/Surveyor Information
Engineer/Surveyor Name: ___________________________________________________
Engineer/Surveyor Address: _________________________________________________
City: ___________________________________ State: ____________ Zip: ______________
Phone #:__________________________ E-mail:_______________________________________

Agent/Attorney Information

Agent/Attorney/Name: ___________________________________________________
Agent/Attorney/Address: _________________________________________________
City: ___________________________________ State: ____________ Zip: ______________
Phone #:__________________________ E-mail:_______________________________________

Other
Name: ___________________________________________________
Address: _________________________________________________
City: ___________________________________ State: ____________ Zip: ______________
Phone #:__________________________ E-mail:_______________________________________