Gwinnett County Planning Division Rezoning Application

Last Updated 12/2015

REZONING APPLICATION AN APPLICATION TO AMEND THE OFFICIAL ZONING MAP OF GWINNETT COUNTY, GA .

APPLICANT INFORMATION . PROPERTY OWNER INFORMATION*

NAME: Embry Development Company, LLC NAME: Mack Thomas Lee , Jr. (deceased)

c/ o Melody A. Glouton , Esq . , Andersen Tate & Carr, P.C. 1960 Satellite Blvd ., Ste 4000 See Attached

ADDRESS: ADDRESS:

Duluth CITY: CITY:

GA 30097 STATE: ZIP: STATE: ZIP:

770-822-0900 770-822-0900 PHONE: PHONE:

CONTACT PERSON: Melody A. Glouton , Esq . PHONE: 770-822-0900

CONTACTS E-MAIL: mglouton@atclawfirm.com

APPLICANT IS THE:

DowNER'S AGENT DPROPERTY OWNER . CONTRACT PURCHASER

R100 TND PRESENT ZONING DISTRICTS(S) : REQUESTED ZONING DISTRICT:

R71 04 029 29 .15 PARCEL NUMBER(S): ACREAGE:

ADDRESS OF PROPERTY: 127 4 Old Peachtree Rd . Lawrenceville , GA 30043

PROPOSED DEVELOPMENT: Single Family Residential Development

RESIDENTIAL DEVELOPMENT NON-RESIDENTIAL DEVELOPMENT

152 Units No. of Buildings/Lots: ______ _

n/a No. of Lots/Dwelling Units _____ _

see Letter of Intent n/a Dwelling Unit Size (Sq. Ft.) : Total Building Sq. Ft. _______ _

+/- 5.21 Units Per Acre n/a Gross Density: _________ _ Density: ___________ _

+/- 5.21 Units Per Acre Net Density: _______ ___ _

PLEASE ATTACH A LETTER oF INTENT EXPLAIN ING WHAT 1s ;~~.t~WED BY

2 NGV 0 2018

RZR 19 00 2 P/aoning&Development

PROPERTY OWNER LIST FOR REZONING APPLICATION

OF EMBRY DEVELOPMENT COMPANY, LLC

Nan1e

Sandra L. Kenerly, Co-Executor of the Estate of Mack Thomas Lee, Jr. * Sharon L. Davis, Co-Executor of the Estate of Mack Thomas Lee, Jr. *

*Letters Testamentary attached hereto.

Address

5220 Belfort Road , Jacksonvill e, FL 32256

5220 Belfort Road , Jacksonvill e, FL 32256

RECEIVED BY NOV 0 1 2018

P/anning&Development

~ZR '1.9 0 0 2

IN THE PROBATE COURT OF G\VINNETT COUN"Im . -STATE OF GEORGIA L 18 JU,tv -! p

IN RE: ESTATE OF

i\1ACK TH01\1AS LEE, JR, DECEASED

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~ ESTATEN~·CL[Rif )

LETTERS TEST Al\1ENT ARY [Relieved of Filing Rei urns J

At a regular tenn of Probate Court~ the Last \\'ill and Testament dated FEBRUARY 27,

1997 of the above-named Decedent, who was domiciled in this County at the time of his death or

was domiciled in another state but owned property in this County at the time of his death, was

legally proven in Solemn Form to be the Decedent's Will and was admitted to record by order,

and it was further ordered that SANDRA L. KENERL Y AND SHARON L. DAVIS named as

Executors in said Will, be allowed to qualify, and that upon so doing, Letters Testamentary be

issued to such Executor.

THEREFORE, the Executors, having taken the oath of office and complied with all

necessary prerequisites of the law, are legally authorized to discharge all the duties and exercise

all powers.ofExecutors under the Will of said Decedent, according to the Decedenfs Will and the

law.

Given under my hand and official seal, the 3 0

NOTE: The following must be signed if the Judge does not sign the original of this document:

Issued by:

Clerk of the Probate Court

GPCSF 5 [15]

[Seal)

R CE\VEOBY NOV 0 1 2018

n£J( ~19 u u t: Planning&Oeve\opment

EfT. July 2017

LEGAL DESCRIPTION FOR 1274 OLD PEACHTREE RD., LAWRENCEVILLE

BEGINNING at a point on the original Land Lot line separating Land Lots 133 and 104 and said point of beginning being 369.70 feet Northeast from the Land Lot comer common to Land Lots 104, 105, 132 and 133; thence North 58 degrees 21 minutes 37 seconds East 833.45 feet to an iron pin found; thence South 31 degrees 53 minutes 00 seconds East 1 708.30 feet to an axle found on Old Peachtree Road; thence South 73 degrees 09 minutes 26 seconds West 138.42 feet to a point; thence South 70 degrees 58 minutes 59 seconds West 143.45 feet to a point; thence South 74 degrees 54 minutes 05 seconds West 102.30 feet to a point; thence South 82 degrees 02 minutes 26 seconds West 98.34 feet to a point; thence North 88 degrees 54 minutes West 94.65 feet to a point; thence North 81 degrees 21 minutes 11 seconds West 75.13 feet to a point; thence North 67 degrees 01 minutes 16 seconds West 124.79 feet to a point; thence North 57 degrees 26 minutes 54 seconds West 123.48 feet to a point; thence North 53 degrees 27 minutes 03 seconds West 168.34 feet to a point; thence North 54 degrees 50 minutes 05 seconds West 102.66 feet to a point; thence North 62 degrees 36 minutes 1 7 seconds West 82.66 feet to an iron pin set; thence North 21 degrees 26 minutes 36 seconds West 188.19 feet to an iron pin set; thence North 32 degrees 36 minutes 29 seconds West 243.92 feet to an iron pin set; thence North 31 degrees 35 minutes 07 seconds West 509.66 to the POINT OF BEGINNING.

Virginia Roberta Lee died testate, a resident of Gwinnett County, Georgia. Her Will has been probated in solemn form at file no. 18-E- /40 in the records of the Probate Court of GwiiUlett County, Georgia. Letters Testamentary have been issued by said Court to ·sandra L. Kenerly and Sharon L. Davis.

TO HAVE AND TO HOLD the said tract or parcel of land, with all and singular the rights, members and appurtenances thereof: to the same being, belonging, or in anywise appertaining, to the only proper use, benefit and behoof of the said Grantee forever in FEE SIMPLE.

AND THE SAID Grantor will warrant and forever defend the right and title to the above described property unto the said Grantee against the claims of all persons whomsoever.

RECE\VEDBY NOV 0 1 2018

Planning&Oeve\opment

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TND TOTAL PROPOSED HOMES 1 52 GROSS RESIDENTIAL DENSITY 5.21 U/AC NET RESIDENTIAL DENSITY 5.21 U/AC 20% COMMON AREA 5.83 AC RESIDENTIAL PARKING 1.5 PER UNIT (IN CL. GARAGE SPACES) AMENITY PARKIN G 15 SPACES MAX. RESID ENTIAL BLDG. H EIGHT 35-FEET

NOTES: 1 l ACCORDING TO FEMA FIRM PANEl. 11 1 J5C0046F EFFECTI VE 09/19/2006 AND GWINNm COUNTY

GIS MAPPING, NO I 00 YEAR FLOOD PLA IN EX ISTS ON THIS SITE. 2J ACCORDING TO U.S. FISH AN D WII.O UFE SERVICE NATIONA l. WETLANDS INVENTORY MAPPING

NO WETLANDS EX IST ON THIS SITF. . 1) ROW•JDA RY SOU RCE: S. R. FIELDS AN D SONS, SU RVEYO RS. DATF. D 7/26/84 4) TOPOGRAPHY SOURCE: GWINN m COUNTY GIS MAPPING 51 SID EWA LKS WI U. BE PROVID ED ACCO RDI NG TO COUNTY STANDARDS. b l SfWF.R AND WATER UTILITIES ARE AVAILABI.E TO THE SITE. i) AU. UTIUTIES WIL L BF.I.OCATF.D UNDERGROUND. B) A PROPERTY OWNERS' ASSOCI ATION WIL L BE F.STA BUSHED. THE ASSOCIATION WILL SET BYLAWS

AN D COVENANTS ACCORDI NG TO COUNTY REQU IRED STANDARDS. THE ASSOCI ATION Wll.l. ASSU ME AU. RES PONSIBIUTIF.S REQUIRED BY THE COUNTY OR DI NANCE.

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TOWN HOME LOT SETBACKS: FRONT 5 ' SIDE 0'/20' BETWEEN BUILD INGS CORNER SIDE 5' REAR (ALLEY) 20' (3 ')

TYPE SIZE YIELD

TOWNHOME LOTS 2 000-5 999 SF 102 SMALL SF LOTS 5,000-7.499 SF 22

MEDIUM SF LOTS 7,500-9.499 SF 28 TOTAL LOTS 152

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Gwinnett County Planning Division Rezoning Application

Last Updated 12/2015

REZONING APPLICANT'S RESPONSE STANDARDS GOVERNING THE EXERCISE OF THE ZONING POWER

PURSUANT TO REQUIREMENTS OF THE UNIFIED DEVELOPMENT ORDINANCE, THE BOARD OF COMMISSIONERS FINDS THAT THE FOLLOWING STANDARDS ARE RELEVANT IN BALANCING THE INTEREST IN PROMOTING THE PUBLIC HEALTH, SAFETY, MORALITY OR GENERAL WELFARE AGAINST THE RIGHT TO THE UNRESTRICTED USE OF PROPERTY AND SHALL GOVERN THE EXERCISE OF THE ZONING POWER.

PLEASE RESPOND TO THE FOLLOWING STANDARDS IN THE SPACE PROVIDED OR USE AN ATTACHMENT AS NECESSARY:

(A) WHETHER A PROPOSED REZONING WILL PERMIT A USE THAT IS SUITABLE IN VIEW OF THE USE AND DEVELOPMENT OF ADJACENT AND NEARBY PROPERTY:

Please see attached

(B) WHETHER A PROPOSED REZONING WILL ADVERSELY AFFECT THE EXISTING USE OR USABILITY OF ADJACENT OR NEARBY PROPERTY: Please see attached

(C) WHETHER THE PROPERTY TO BE AFFECTED BY A PROPOSED REZONING HAS REASONABLE ECONOMIC USE AS CURRENTLY ZONED: Please see attached

(D) WHETHER THE PROPOSED REZONING WILL RESULT IN A USE WHICH WILL OR COULD CAUSE AN EXCESSIVE OR BURDENSOME USE OF EXISTING STREETS, TRANSPORTATION FACILITIES, UTILITIES, OR SCHOOLS: Please see attached

(E) WHETHER THE PROPOSED REZONING IS IN CONFORMITY WITH THE POLICY AND INTENT OF THE LAND USE PLAN: Please see attached

(F) WHETHER THERE ARE OTHER EXISTING OR CHANGING CONDITIONS AFFECTING THE USE AND DEVELOPMENT OF THE PROPERTY WHICH GIVE SUPPORTING GROUNDS FOR EITHER APPROVAL OR DISAPPROVAL OF THE PROPOSED REZONING:

Please see attached

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P/anning&Oevelopm

REZONING APPLICANT EMBRY DEVELOPMENT COMPANY, LLC'S RESPONSE TO STANDARDS GOVERNING THE EXERCISE OF ZONING POWER

A) WHETHER A PROPOSED REZONING WILL PERMIT A USE THAT IS SUITABLE IN VIEW OF THE USE AND DEVELOPMENT OF ADJACENT AND NEARBY PROPERTY:

Yes. The proposed Rezoning Application will permit a use that is suitable in view of the use and development of the adjacent and nearby property. The property is close to Buford Drive and is near land zoned C-2, 01, MUO, R-100, and R60.

B) WHETHER A PROPOSED REZONING WILL ADVERSELY AFFECT THE EXISTING USE OR USEABILITY OF ADJACENT OR NEARBY PROPERTY:

No. The proposed Rezoning Application will not adversely affect the existing use or usability of any of the nearby properties.

C) WHETHER THE PROPERTY TO BE AFFECTED BY A PROPOSED REZONING HAS REASONABLE ECONOMIC USE AS CURRENTLY ZONED:

Due to the size, location, layout and dimensions of the subject property, the Applicant submits that the property does not have reasonable economic use as currently zoned.

D) WHETHER THE PROPOSED REZONING WILL RESULT IN A USE WHICH WILL OR COULD CAUSE AN EXCESSIVE OR BURDENSOME USE OF EXISTING STREETS, TRANSPORTATION FACILITIES, UTILITIES, OR SCHOOLS:

No, the proposed rezoning will not result in an excessive or burdensome use of the infrastructure systems. The property has convenient access to Buford Highway as well as Interstate 85.

E) WHETHER THE PROPOSED REZONING IS IN CONFORMITY WITH THE POLICY AND INTENT OF THE LAND USE PLAN:

Yes. The proposed rezoning application is in conformity with the policy and intent of the Gwinnett County Land Use Plan. The property is designated as within the Existing/Emerging Character Area, which encourages residential infill development and single-family detached and townhouse developments, specifically.

F) WHETHER THERE ARE OTHER EXISTING AFFECTING THE USE AND DEVELOPMEN•~r;;;\:~

ll 'l0 J 2 NUV 0 1 2018

P/anning&Development

GIVE SUPPORTING GROUNDS FOR EITHER THE APPROVAL OR DISAPPROVAL OF THE ZONING PROPOSAL:

The applicant submits that the subject property's proximity to Interstate 85, Buford Drive and nearby zon ing of C-2 , 01 and MUO provide add itional support of this application.

3309300_l .DOC

RECEIVED BY NUV 0 1 2018

P/anning&Developmeni

ANDERSEN I TATE I CARR Melody A. Glouton Email: mglouton@atclawfirm.com

October 31, 2018

VIA HAND DELIVERY Gwinnett County Planning and Development c/o Kathy Holland, Director of Planning and Development 446 West Crogan Street Lawrenceville, GA 30046-2440

Telephone: 770.822.0900

Direct Dial: 770.339.0475

Direct Fax: 770.236.9719

RECEIVED BY NOV 0 1 2018

P/anning&Oevelopment RiR '19 UU?

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RE: LETTER OF INTENT FOR REZONING APPLICATION OF EMBRY DEVELOPMENT COMPANY, LLC

Dear Director and Staff:

Andersen Tate & Carr, P.C. submits this Letter of Intent and attached Rezoning Application on behalf of Embry Development Company, LLC (the "Applicant") for the purpose

of requesting the rezoning of an approximate 29.15-acre tract (the "Property") located on Old Peachtree Road near the intersection of Buford Drive in northeast Gwinnett County. The Property is currently zoned R-100. The Applicant proposes to develop a distinctive and attractive single-family residential community under the Traditional Neighborhood Development District (TND) consisting of 152 homes with a variety of house style and designs. The proposed development would be served by one entrance on Old Peachtree Road.

The proposed development would include three different home types, including 102 townhomes and 50 detached homes on medium and small lots as set forth in the Gwinnett

County Unified Development Ordinance (the "UDO"). The proposed community would also include a mix of front and rear entry homes. Townhomes would be a minimum of 1,800 square feet and the detached single-family homes would be a minimum of 2,000 square feet. The proposed townhomes are positioned toward the front of the development with the medium and

small lot detached homes situated internally and along the rear and east side of the Property. Pursuant to the requirements of the UDO, the proposed development must include a 50-foot wide natural undisturbed buffer. The proposed development also includes a large open space on the west side of the property, and eight pocket parks throughout the development which would provide a recreational opportunity for residents. The pocket parks would include pedestrian amenities which would connect to sidewalks in the development creating a walkable environment and promoting healthy lifestyle. The proposed pool and clubhouse located at the front of the development would also create an activity center and gathering place for residents

Andersen, Tate & Carr, P.C. • One Sugarloaf Centre • Suite 4000 • 1960 Satellite Boulevard • Duluth GA 30097 • www.atclawfirm.com

fostering a sense of community. Including the open space and proposed pocket parks, the development provides for 5.83 acres of common area which is 20% of the Property's gross acreage. In addition to internal walkability, residents would be able to walk to a wide variety of

commercial and retail uses located at the intersection of Old Peachtree Road and Buford Drive, including various restaurants, Publix shopping center, and Gwinnett Coolray Field.

The proposed community would consist of homes at a size, quality, and price-point

commensurate with or exceeding homes in the surrounding area. The proposed townhomes would include double-car garages as well as attractive architectural elements which are compatible with the surrounding area. The front facades of the homes would be constructed primarily of brick, stone, shake/siding, and/or board and batten as depicted in the building elevations submitted with the Application.

The Gwinnett County 2030 Unified Plan (the "2030 Plan") provides that "promoting a

variety of housing options for Gwinnett County residents is one of the policy goals of the Unified Plan." Moreover, the 2030 Plan encourages "single family detached and townhome

developments at low to moderate densities" and "residential in-fill development at densities and architectural character compatible with existing development." The proposed development is compatible with the spirit and intent of the 2030 Plan especially when considering that the Property is located in close proximity to land zoned C-2, OI, and MUO.

The Applicant and its representatives welcome the opportunity to meet with staff of the Gwinnett County Department of Planning & Development to answer any questions or to address any concerns relating to the matters set forth in this letter or in the Rezoning Application filed

herewith. The Applicant respectfully requests your approval of this Application.

Respectfully submitted this 31st day of October, 2018.

ANDERSEN TATE & CARR, P.C.

~~"?( ~Jv~ Melody A. Gl uton, Esq. Attorneys for Applicant

RECBVEDBY NUV 0 1 2018

P/anning&Oevelopment

Gwinnett County Planning Division Rezoning Application Last Updated 2/20 14

REZONING APPLICANT'S CERTIFICATION

THE UNDERSIGNED BELOW IS AUTHORIZED TO MAKE THIS APPLICATION. THE UNDERSIGNED IS AWARE THAT NO APPLICATION OR REAPPLICATION AFFECTING THE SAME LAND SHALL BE ACTED UPON WITHIN 12 MONTHS FROM THE DATE OF LAST ACTION BY THE BOARD OF COMMISSIONERS UNLESS WAIVED BY THE BOARD OF COMMISSIONERS. IN NO CASE SHALL AN APPLICATION OR REAPPLICATION BE ACTED UPON IN LESS THAN SIX (6) MONTHS FROM THE DATE OF LAST ACTION BY THE BOARD OF COMMISSIONERS.

Type or Print Name and Title

4

Date

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P/anning&Oeve

Gwinnett County Planning Division Rezoning Application

Last Updated 12/20 IS

REZONING PROPERTY OWNER'S CERTIFICATION

THE UNDERSIGNED BELOW, OR AS ATTACHED, IS THE OWNER OF THE PROPERTY CONSIDERED IN THIS APPLICATION. THE UNDERSIGNED IS AWARE THAT NO APPLICATION OR REAPPLICATION AFFECTING THE SAME LAND SHALL BE ACTED UPON WITHIN 12 MONTHS FROM THE DATE OF LAST ACTION BY THE BOARD OF COMMISSIONERS UNLESS WAIVED BY THE BOARD OF COMMISSIONERS. IN NO CASE SHALL AN APPLICATION OR REAPPLICATION BE ACTED UPON IN LESS THAN SIX (6) MONTHS FROM THE DATE OF LAST ACTION BY THE BOARD OF COMMISSIONERS.

Signature of Property Owner

I I

Date

The Estate of Mack Thomas Lee, Sandra Kenerly, Co-Executor

Type or Print Name and Title

Date

5

R CE\VE B ~ ov 0 1 2018

Planning&Oeve\opment ,;{.!;·,; '1;9 .I 12,

Gwinnett County Planning Division · Rezoning Application

Last Updated 12/20 IS

REZONING PROPERTY OWNER'S CERTIFICATION

THE UNDERSIGNED BELOW, OR AS ATTACHED, IS THE OWNER OF THE PROPERTY CONSIDERED IN THIS APPLICATION. THE UNDERSIGNED IS AWARE THAT NO APPLICATION OR REAPPLICATION AFFECTING THE SAME LAND SHALL BE ACTED UPON WITHIN 12 MONTHS FROM THE DATE OF LAST ACTION BY THE BOARD OF COMMISSIONERS UNLESS WAIVED BY THE BOARD OF COMMISSIONERS. IN NO CASE SHALL AN APPLICATION OR REAPPLICATION BE ACTED UPON IN LESS THAN SIX (6) MONTHS FROM THE DATE OF LAST ACTION BY THE BOARD OF COMMISSIONERS.

Signature of Property Owner Date

The Estate of Mack Thomas Lee, Sharon Davis, Co-Executor

Type or Print Name and Title

Sign ture of Notary Public Date

RECE\VEDBY NOV 0 1 LU .,}

5 Planning &Oevelonment

Gwinnett County Planning Division Rezon ing Application Last Updated 2/2014

CONFLICT OF INTEREST CERTIFICATION FOR REZONING

The undersigned below, making application for a Rezoning, has complied with the Official Code of Georgia Section 36-67 A-I, et. seq, Conflict of Interest in Zon ing Actions, and has submitted or attached the required information on the forms provided.

DATE TYPE OR PRINT NAME AND TITLE

SIGNATURE OF APPLICANT'S ATTORNEY OR REPRESENTATIVE

'

DATE

DISCLOSURE OF CAMPAIGN CONTRIBUTIONS

Have you, within the two years immediately preceding the filing of this application, made campaign contributions aggregating $250.00 or more to a member of t he Board of Commissioners or a member of the Gwinnett County Planning Commission?

DYES KJ NO YOUR NAME

If the answer is yes, please complete the following section:

NAME AND OFFICAL CONTRIBUTIONS DATE CONTRIBUTION

POSITION OF GOVERNMENT (List all which aggregate WAS MADE

OFFICIAL to $250 or More) (Within last two years)

Attach additional sheets if necessary to disclose or describe all contributions.

RECBV DBY :; ~ I I/ ·:) I j I J .·

NOV 0 1 201 6

Planning &Developm

Gwinnett County Planning Division Rezoning Application

Last Updated 12/20 IS

CONFLICT OF INTEREST CERTIFICATION FOR REZONING

The undersigned below, making application for a Rezoning, has complied with the Official Code of Georgia Section 36-6 7 A-1, et. seq, Conflict of Interest in Zoning Actions. and has submitted or attached the required information on the forms provided.

SIGNATURE OF APPLICANT DATE TYPE OR PRINT NAME AND TITLE

Melody A. Glouton, Attorney

ATTORNEY OR REPRESENTATIVE

d<v7~a_fi,a_,t-?t IIJ· ?JO·Jf

SIGNATURE OF NOT A Y PUBLIC DATE

Have you, within the two years immediately preceding the filing of this application, made campaign contributions aggregating $250.00 or more to a member of the Board of Commissioners or a member of the Gwinnett County Planning Commission?

~YES D Andersen, Tate & Carr, P.C. NO

YOUR NAME

If the answer is yes, please complete the following section:

NAME AND OFFICAL CONTRIBUTIONS DATE CONTRIBUTION POSITION OF (List all which aggregate to WAS MADE

GOVERNMENT OFFICIAL $250 or More) (Within last two years) Please see attached

Attach additional sheets if necessary to disclose or describe all contributions.

RECEIVED y ·;/I· '·p.) U I/ il·.,·~ ,..;.. ,;I t ~

6 NUV 0 1 2018

P/anning&Oevelopment

EXHIBIT BAND DISCLOSURE OF CAMPAIGN CONTRIBUTIONS BY ANDERSEN, TATE & CARR, P.C., ATTORNEY FOR APPLICANT

NAME AND OFFICIAL POSITION OF CONTRIBUTIONS DATE CONTRIBUTION GOVERNMENT OFFICIAL WAS MADE

Charlotte Nash $1,000 March 2016 Commission Chairman $500 October 20, 2016

$578.10 October 20, 2016

Jace Brooks $500 March 2016 District 1 Commissioner

Tommy Hunter, $500 January 27, 2016 District 3 Commissioner

Lynette Howard $500 April 10, 2018 District 2 Commissioner

John Heard $500 June 15, 2018 District 4 Commissioner

RECEIVE BY NOV 0 1 2018

P/anning&Development

Gwinnett County Planning D ivision Rezoning Appl ication Last Updated 2120 14

VERIFICATION OF CURRENT PAID PROPERTY TAXES FOR REZONING

THE UNDERSIGNED BELOW IS AUTHORIZED TO MAKE THIS APPLICATION. THE UNDERSIGNED CERTIFIES THAT ALL GWINNETT COUNTY PROPERTY TAXES BILLED TO DATE FOR THE PARCEL LISTED BELOW HAVE BEEN PAID IN FULL TO THE TAX COMMISSIONER OF GWINNETT COUNTY, GEORGIA. IN NO CASE SHALL AN APPLICATION OR REAPPLICATION FOR REZONING BE PROCESSED W ITHOUT SUCH PROPERTY VERIFICATION.

*Note: A SEPARATE VERIFICATION FORM MUST BE COMPLETED FOR EACH TAX PARCEL INCLUDED IN THE REZONING REQUEST.

PARCEL I.D. NUMBER: (Map Reference Number)

R

District

/ Signature of A pl ican( L L / ~

::Jo_ W\ .e 5 V1A C W\ r (}=: Type or Print Name and Title

7104 029

Land Lot Parcel

/()-5'/- Zotc? Date

TAX COMMISSIONERS USE ONLY

(PAYMENT OF ALL PROPERTY TAXES BILLED TO DATE FOR THE ABOVE REFERENCED PARCEL HAVE BEEN VERIFIED AS PAID CURRENT AND CONFIRMED BY THE SIGNATURE BELOW)

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