Street Address, City, State, Zip Code
Subdivision Lot & Parcel # and/or Tax Map Designation
(if applicable)
(if required)
Check all applicable below:
All adjacent property owners shall be listed. Adjacent property owners include all property across from roadways, watercourses, railroads, and/or municipal boundaries. The names and addresses below are those of adjacent property owners as listed in the tax records of the City Assessor and County Assessor if applicable.
The City Clerk on behalf of the City Council will send a letter to the applicant, with the approved ordinance including all proffers approved with the rezoning. Upon consideration of the proposed rezoning, the City Council shall consider the following factors and shall concur therein before acceptance of any of the additional conditions proffered.
(list all items)
With the signing of this form, the property owner certifies that no cash contribution to the City has been solicited or offered as part of the proffer; as has no mandatory dedication of real or personal property, on- or off-site, for open space, parks, schools, fire departments or other public facilities.
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