Modification Application Form - Anne Arundel County Maryland
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1MODIFICATION APPLICATION
Date:
________________________________
Property Owner: ______________________________ Consultant: ______________________________________
Address: _____________________________________ Address: _________________________________________
______________________________________
_________________________________________
Phone No. ____________________________________ Phone No. ________________________________________
Email Address (Req'd) _________________________ Email Address (Req'd) ______________________________
1.
Modification Types: (Indicate the type of modifications requested)
Process:______Major______Sketch ______Minor______Amended Plat_______SDP ____Preliminary Plan ____ Other
Subdivision Standards:_____Road improvements______Water extension______Sewer extension ____ Recreation Area
______Street trees______Lot size______Lot ratio______Lot density ___PUD Setbacks
Design Manual Standards:______Cul de sac______Right of way width______Pavement width ____Sight Distance
______Road radius______Road intersection spacing
Environmental:______Steep Slopes______Specimen Trees______Wetland Impacts______Buffers
Flood Plain: _____
Other:(specify)_____________________________________________________________________________
2.
Development Types: (Check & complete appropriate category for in-process projects.
Include a Development Application if no in-process project or permit.)
____ Subdivision: Name:_______________________________________________________________________
Subdivision #S_____________________________
Project #P________________________________
____ Site Development Plan: Name:______________________________________________________________
Site Plan #C __________________________
____ Permit
#G____________________________
#B____________________________
3.
Location
Address: ________________________________________________________________________________________
Tax Map_________ Block/Grid _________ Parcel _______________ Size of Tract (Acreage) _______________
Tax ID (Req’d 12 digit number) _____________________________________
Tax Assessment District_______ Councilmanic District________ # of new units_______ Critical Area Y N
4.
A DETAILED Letter of Explanation that includes a description of each modification request and
a justification is required. List below the Code Sections to which this application applies:
Section Reference Number (e.g., 17-4-202)
Summary of Regulation (e.g., Site Development)
#1.__________________________
___________________________________________
#2.__________________________
___________________________________________
#3.__________________________
___________________________________________
#4.__________________________
___________________________________________
5.
Is this project/permit the subject of a violation? Y N
Violation # __________________
SIGNATURE: (OWNER/CONSULTANT)____________________________________DATE_____________________
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