Appeal or Variance Application

APPLICATION FOR VARIANCE

OR APPEAL TO BOARD OF APPEALS

Name of Appellant___________________________________________________________________________________________

Mailing Address_____________________________________________________________________________________________

City or Town _____________________________________________ State_________________________ Zip_________________

Telephone _____________________________________________Email_______________________________________________

Name of Property Owner if Different from Appellant _______________________________________________________________

The undersigned requests that the Board of Appeals consider one of the following:

_______1. Administrative Appeal: Relief from the decision, or lack of decision, of the Code Enforcement Officer or Planning Board in regard to an application for a permit or violation. The undersigned believes that (check one):

______ An error was made in the denial of the permit

______ The denial of the permit was based on a misinterpretation of the Ordiance

______ There has been a failure to approve or deny the permit within a reasonable period of time

______ other _________________________________________________________________________________

_____________________________________________________________________________________

Please explain in more detail the facts surrounding this appeal (please attach a separate piece of paper). You should be as specific as possible so that the Board of Appeals can give full consideration to your case.

_______ 2. A Variance:

A. Nature of Variance: Describe the nature of the Variance ___________________________________________

___________________________________________________________________________________________

___________________________________________________________________________________________

___________________________________________________________________________________________

In addition, a sketch plan of the property must accompany this application showing dimensions and shape of the lot, the size and locations of existing buildings, the locations and dimensions of proposed buildings or alterations, and any natural or topographical peculiarities of the lot in question.

Signature _________________________________________________________ Date ___________________________________

For Office Use Only:

Date Received ______________________ Date Paid: _______________________ Amount Paid: __________________________