Norfolk, Conditional Use Permit Application
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1
2CONDITIONAL USE PERMIT
APPLICATION-FORM A
1. Applicant’s name
2. Applicant’s address
3. Telephone number (home)
(business)
4. Present use of property
5. Desired use of property
6. Request for Conditional Use Permit
Perpetual
Be issued for
years
7. Legal Description of property:
Street address and location
Legal Description
8. Area of subject property (sq. feet or acres)
9. Describe the general character of the area.
Signature of owner:
Signature of Authorized Agent:
309 N 5th Street; Norfolk, NE 68701
Rev: 05-2016
Return Completed forms to: Norfolk Planning Commission; 701 Koenigstein; Norfolk, NE 68701
Rev: 02-2004
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Parent category: Business