Critical Area Reclassification Application - Anne Arundel County printable pdf download

For Office Use Only

ZONE _________

CASE # ______________________

CRITICAL AREA: IDA ___ LDA ___ RCA____

FEE PAID____________________

BMA: Yes _____ No ______

DATE _______________________

NO. OF SIGNS ___________

CRITICAL AREA RECLASSIFICATION APPLICATION

Applicant(s): ___________________________________________________________________________________

(Applicant must have a financial, contractual, or proprietary interest in the property)

Property Address: ______________________________________________________________________________

Property Location:______ feet of frontage on the (n, s, e, w) side of ____________________________ (St, Rd, Ln, etc.);

_________ feet (n, s, e, w) of (Nearest intersecting street) _________________________________ (St, Rd, Ln, etc.).

12-digit Tax Account Number _______________________ Tax District __________ Council District ____________

Waterfront Lot (circle)

Corner Lot (circle)

Y N

Deed Title Reference _____________________

Zoning District _________

Lot # ________ Tax Map _______ Block/Grid _________ Parcel _____________

Area (sq.ft. or acres) _________________ Subdivision Name ___________________________________________

Proposed Critical Area Classification (from/to) __________________________________________

Description of Critical Area Reclassification Requested (

include narrative providing justification for reclassification)

__________________________________________________________________________________________________

The applicant hereby certifies that he or she has a financial, contractual, or proprietary interest equal to or in excess of 10 percent of

the property; that he or she is authorized to make this application; that the information shown on this application is correct; and that he

or she will comply with all applicable regulations of Anne Arundel County, Maryland.

Applicant’s Signature ___________________________ Owner’s Signature ____________________________________

Print Name ___________________________________ Print Name __________________________________________

Mailing Address _______________________________ Mailing Address ______________________________________

City, State, Zip ________________________________ City, State, Zip ________________________________________

Phone ________________________________________ Phone ______________________________________________

(Work)

(Home)

(Work)

(Home)

Cell Phone ____________________________________ Cell Phone ___________________________________________

Email Address _________________________________ Email Address ________________________________________

* * * Below For Office Use Only * * *

Application accepted by Anne Arundel County, Office of Planning and Zoning: ______________________________________

Initials

Date

Critical Area Reclassification _________________________________________________________________________________

___________________________________________________________________________________________________________

Rev 10/05/15

Critical Area Reclassification Application - Anne Arundel County

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