The undersigned requests a CERTIFICATE OF APPROPRIATENESS as specified below. Should this
BOARD OF ARCHITECTURAL REVIEW - APPLICATION FOR
CERTIFICATE OF APPROPRIATENESS
Application #
The undersigned requests a CERTIFICATE OF APPROPRIATENESS as specified below. Should this
application be approved, it is understood that it shall only authorize that particular use described in this application and any
conditions or safe guards required by the Board. Granting of a Certificate of Appropriateness does not exempt the
applicant from complying with all of the requirements of building, housing, and other regulations. The applicant
understands that the administrative official is authorized to review all Certificates of Appropriateness granted by the Board,
to inspect the land or structure in order to ascertain compliance with all conditions attached by the Board to the Certificate
of Appropriateness.
1. NAME OF OWNER MAILING ADDRESS PHONE NUMBER HOME BUSINESS
2. NAME OF APPLICANT (if owner)
MAILING ADDRESS PHONE NUMBER: HOME____________________ BUSINESS
LOCATION DESCRIPTION: PROPERTY ADDRESS I. DEED BOOK & PAGE NO. (attach a legal description)
3. EXISTING USE
4. PROPERTY PRESENTLY ZONED AS ORDINANCE NO.:
5. DESCRIPTION OF PROPOSED CHANGES
6. Please submit the following information with the application. Include a list of the items attached. New Construction - Scaled drawings, site plan, photographs, materials list and sample materials.
Reconstruction/Restoration/Addition/Alteration - Scaled drawings, site plan, photographs (historic if available), materials list.
Demolition - Photographs, current valuation (from a licensed real estate appraiser), demolition cost including removal of debris and finish grading.
Signage - Scaled drawing of sign, location, and photograph of building. Additional materials may be requested at any point
during the process to insure the Board has adequate information for review. If materials requested fail to be submitted by
the deadline, the application will be excluded from the agenda and will not be placed on the agenda until all requests are
satisfied. If materials requested fail to be submitted by the deadline, the application will be excluded from the
agenda and will not be placed on the agenda until all requests are satisfied.
_____________________________ ___________________________
Owner's Signature Date
_____________________________ ___________________________
Applicant's Signature Date