This rezoning application provides details about a requested rezoning for a property located at [ADDRESS]. The applicant, [NAME], is requesting to rezone the [APPROXIMATE SIZE] tract of land from its existing land use of [EXISTING LAND USE] to [REQUESTED REZONING]. If approved, the applicant plans to [PROJECT DESCRIPTION]. Contact information is provided for the applicant, engineer, and property owner. The application lists the required utility providers and reviewers that will need to approve the project. In the legal justification section, the applicant references elements of the comprehensive plan and zoning ordinance to support the requested zone change.

1. REZONING APPLICATION
Georgetown-Scott County Planning Commission
Name of Applicant:
Project Name:
Date Filed: Fee:
Property Information
Address ( Street Number and Name):
Approximate Size of Tract: _______ acres ______ sq. ft.
Sanitary Sewer Available: ____ yes ____ no Existing Land Use (Ag., SF Res. etc.):
Requested Rezoning:
From _________ To: __________
Project Description (type, # of units, etc.):
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All correspondence relating to this application should be mailed to:
Contact Person
Address:
Phone: Fax:
email:
Engineer/Reg. Land Surveyor/Consultant:
Address:
Phone: Fax:
email:
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2. Owner(s) Information (Names of all property owners involved must be listed below):
Name Address City/State Phone
AUTHORIZATION OF APPLICATION:
I hereby certify that I am the authorized applicant or owner, representing ALL property owners involved
in this request or holders of option on same, as listed above.
Name (print): ____________________________ Signature: _____________________________
Address (if different than previously listed): __________________________________________
Utility Providers (check all that apply) Other Reviewers (to be filled out by P&ZS)
_______ A T & T _______ Health Department
_______ Georgetown Municipal Water and Sewer _______ KYTC District #7
_______ Kentucky American Water _______ Soil Conservation
_______ Kentucky Utilities _______ City Fire Dept.
_______ Owen Electric (Owen County RECC) _______ County Fire Dept.
_______ Bluegrass Energy (Harrison County RECC) _______ City Road Dept.
_______ Columbia Gas _______ County Road Dept.
_______ Delaplain Disposal _______ City Engineer
_______ City Police
_______ Emergency Management Services
_______ Time Warner Cable
_______ Building Inspection
Please state the legal justification for the requested zone change (reference the adopted Comprehensive
Plan/Land Use Plan, Zoning Ordinance, availability of utilities, etc.):
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