Application No. ________     Filed: _______                    __________________
                                                                                                (Board Secretary)

This Application must be filed fifteen (15) days before date of hearing. 

1. Application is hereby made by:

   ____________________________________________________________________________________
   (Name of Applicant)

   ____________________________________________________________________________________
   (Address)
   

2. To (state relief requested, i.e. reverse action of Building Inspector; grant variance, exception, etc.)

   ____________________________________________________________________________________

   ____________________________________________________________________________________

   ____________________________________________________________________________________

3. For property at ________________________________________________________________________
                                   (No.)                                      (Street)

   Known as Lot No. ______ Block No. __________ Zone __________

4. The applicant is the owner of the property involved. If applicant is other than the owner, state the basis on which the application is made, i.e., Purchaser under Contract with the owner, and owner must sign consent and authorization at end of application.
   
5. The section(s) of the Zoning Ordinance governing the property in question is (are):

   __________________________________________________________________________________

6. Reasons upon which Applicant will rely are: __________________________________________________________________________________

Applicants furnish herewith a plot plan of the land which is the subject of this application, showing existing and proposed buildings or proposed additions thereto, and such detail with respect to adjacent and nearby properties as is required for a proper consideration of the application, certified by an Engineer or Surveyor licensed in the State of New Jersey, and such other drawings as will enable the Board to properly consider the application.

I Certify that all of the above statements and the statements contained in all exhibits submitted herewith, are true. Further, to the best of my knowledge, a variance has never been applied for previously to the Zoning Board of Adjustment for the subject property.

_____________________________________
(Applicant'sSignature)

_____________________________________
(Address)

 

Dated:________________

(If applicant is not owner of premises, Owner(s) must sign this consent)

The undersigned, owner(s) of the premises described in Paragraph 3, consent(s) to the foregoing application and agree(s) to be bound by the action taken thereon.

_____________________________________
(Owner’s Name)

_____________________________________
(Owner’s Signature)

_____________________________________
(Owner’s Address)

Dated: ________________