In support
of my appeal to the Zoning Hearing Board, I submit this letter of request,
which specifically describes the relief I request from the Board. This description fully statues the use,
structure or other item I request be allowed, sets forth specific dimensions
and notes all of the relief I request be considered. (Please attach additional documents if required)
Specific Description of
Proposed Use, Structure, Etc.
(The
appellant must attach plans or drawings showing specific use, dimensions, lot lines)
Specific Relief Requested
The facts
set forth in this letter of request and attachments are true and correct, and
are made subject to the provisions of Title 18 Pa. Crimes Code S/S 4904 (unsworn falsification to authorities).
Date:
______________________
______________________________
ZONING HEARING
BOARD
I/We hereby request a hearing before the Zoning Hearing Board of Harborcreek Township. In support of the appeal I/We submit the following information and a letter of request form.
1.
Address of
Property:_______________________________________________________
2.
Township Index No.:___________________ 3. Zoning
Classification:_________________
4. Name of Appellant:_______________________________________________________
5. Address of Appellant(if
different):___________________________________________
6. Appellants Telephone Number:
(Home)_______________ (work)___________________
7. Appellants Status (check one): Record Owner_______ Lessee____________
Agreement to Purchase_____________________
I request the following relief: Variance________________________________
Special Exception_________________________
Declaration that Use Permitted_______________
Certificate of Nonconforming Use_____________
Expansion of Nonconforming Use_____________
Other (please explain):_____________________
_______________________________________
8. Applicable Provisions of
Zoning Ordinance (to be completed by Code Enforcement Office)
_______________________________________________________________________________
_______________________________________________________________________________
9. State General nature and
extent of relief requested:
_______________________________________________________________________________
_______________________________________________________________________________
Date:_________________________
Appeal
No. Assigned:_________________________________
Signature
of Appellant:_________________________________________________