Board of Appeals Application

Board of Appeals Application

For additional information, please refer to the Town of Galena Charter and Code at https://ecode360.com/GA3097/home
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Appeal Type:
Property Address
Parcel
Subdivision
Lot/Unit
Zoning District
Lot Size (in acres)
Existing Structures on Property
Are you the property owner?
If no, please provide the name, address, phone and email of the property owner
Please describe in detail the basis for the appeal
Date of decision you are appealing

MonthDayYear
Date
Please describe exactly what approval or relief is being requested
Please explain why the request is needed and why the property cannot reasonably comply with the decision/ordinance
Name, Phone & Email of Adjoining Property Owners
PLEASE UPLOAD THE FOLLOWING DOCUMENTATION:
- Site plan or sketch
- Property survey (if available)
- Supporting photos
- Letters of Consent/Support from adjoining property owners and others
- Any other supporting documentation to this request
File Upload

Cancelof
Additional Information / Questions
By signing and submitting this application, the applicant affirms that they are the property owner or are otherwise authorized to submit this application on behalf of the property owner or entity identified herein. The applicant further certifies that all information, statements, plans, and supporting materials submitted in connection with this application are true, accurate, and complete to the best of their knowledge and belief. The applicant acknowledges that submission of false, misleading, or incomplete information may result in denial of the application, revocation of any approval granted, or other enforcement action as authorized by the Town of Galena Zoning Ordinance or applicable law.
Signature
Date

MonthDayYear
Date
Should be Empty: