Zoning Appeal Application

Zoning Appeal Application
Applicant Information
Applicant/Appellant Name

First NameMiddle NameLast Name
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Do you own the property in question?
If not, give name and address of owner(s)
***Owner must be present at the Zoning Hearing Board Meeting***
Name of Attorney, if any
Interest of appellant/applicant if not owner
Appeal Details
Appeal Application Relates To
Location of Real Estate Affected
Present Use (Indicate vacant, residence, commercial, etc.)
Zoning District (R-1, R-2, R-3, OS, O, CC, CH, I-1, I-2)
Date Determination Made by Zoning Officer

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Reason applicant/appellant believes board should approve action and whether hardship is claimed, and specific hardships.
Signature and Affidavits
Applicant/Appellant Signature
Affidavit #1
The undersigned has applied to the Zoning Hearing Board of Adjustment for:
A Hearing will be held on:
At 6:30 PM in Council Chambers or Auditorium, City Hall, Hazleton, PA. Persons objecting may appear at that time. I do hereby certify that I will post the within notice on the premises ten (10) days prior to the date of the hearing.
Property Owner Signature (Owner must be present at hearingAlong with copy of deed.)
Appellant Name

First NameLast Name
Property Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Tenant Signature (if applicable)
Application Number
***In event owner cannot attend hearing***Affidavit #2
The undersigned has applied to the Zoning Hearing Board of Adjustment for:
A Hearing will be held on:
At 6:30 PM in Council Chambers or Auditorium, City Hall, Hazleton, PA. Persons objecting may appear at that time. I do hereby certify that I will post the within notice on the premises ten (10) days prior to the date of the hearing.
Property Owner Signature
Property Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Application Number
Should be Empty:

Zoning Appeal Application

Applicant Information

***Owner must be present at the Zoning Hearing Board Meeting***

Appeal Details

Signature and Affidavits

Affidavit #1

At 6:30 PM in Council Chambers or Auditorium, City Hall, Hazleton, PA. Persons objecting may appear at that time. I do hereby certify that I will post the within notice on the premises ten (10) days prior to the date of the hearing.

***In event owner cannot attend hearing***Affidavit #2

At 6:30 PM in Council Chambers or Auditorium, City Hall, Hazleton, PA. Persons objecting may appear at that time. I do hereby certify that I will post the within notice on the premises ten (10) days prior to the date of the hearing.

Owner must be present at the Zoning Hearing Board Meeting

In event owner cannot attend hearingAffidavit #2