Application for Zoning Permit

______ Application No. Miami Township, Greene County, Ohio

To the Board of Township trustees:

The undersigned hereby applies for a zoning permit for the following use described, based on the information provided herein, all of which the applicant swears to be true:

Location of property_________________________________________________________________________

__________________________________________________________Tax parcel no.____________________

Name of property owner____________________________________________________ Phone ___________

Address of property owner____________________________________________________________________

Occupant of property_______________________________________________________ Phone ___________

Name of applicant_________________________________________________________ Phone ___________

Address of applicant_________________________________________________________________________

Existing use________________________________________________________________________________

Proposed use:_______________________________________________________________________________

Drawing of lot showing road frontage, existing structures, and proposed construction. Include the least distance of all structures from property lines and all distances of proposed construction from property lines.

Height of the proposed structure above average grade_______________

Use of proposed structure________________________ Estimated cost of proposed construction____________

Remarks:_________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Witness____________________________________ Applicant_____________________________________

Date filed with Zoning Inspector ___________________________ Present Zoning ________ Fee__________