West Memphis, AR

Application Check List

Petition for Variance Request Should Include One or More of the Following:
1. Petition for Variance Request. (Filing fee of $35.00) 2. Applications should be presented to the Planning and Development Department at least 15 days prior to the meeting date. (The meeting date is always the second Thursday in each month unless otherwise notified.) 3. All applications and notices should include a street address and legal description. 4. Property must be posted for a Variance Request. ($25 sign deposit - City will provide sign.) 5. Public notice to be taken to the newspaper so it can be published at least 1 time, 7 days, prior to the public hearing date. (Notice fee varies by advertisement length and fee is responsibility of applicant.) 6. After approval, the applicant may obtain the necessary permit.
1. Petition for Variance Request. (Filing fee of $35.00)
2. Applications should be presented to the Planning and Development Department at least 15 days prior to the meeting date. (The meeting date is always the second Thursday in each month unless otherwise notified.)
3. All applications and notices should include a street address and legal description.
4. Property must be posted for a Variance Request. ($25 sign deposit - City will provide sign.)
5. Public notice to be taken to the newspaper so it can be published at least 1 time, 7 days, prior to the public hearing date. (Notice fee varies by advertisement length and fee is responsibility of applicant.)
6. After approval, the applicant may obtain the necessary permit.
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Application

Petition Case Number
Filing Date
Applicant's Name
Mailing Address
Phone Number
Fax Number
Request Is Hereby Made to Make a Determination in the Following Matter:
1. Extension into a District
2. Grant a General Exception
3. Grant a Special Exception
4. Grant a Variance
5. Grant Rehearing
6. Locate District Boundary
7. Overrule Inspector's Decision
8. Resolve a Special Question
9. Other
Other
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Premises in Question

Owner of Premises
Phone Number
Fax Number
Address of Premises in Question
Legal Description
Lot
Block
Subdivision
Present Zone
Lot Size
Present Use
Present Improvements on Parcel
Proposed Use
This Application Is Hereby Referred to the Board of Adjustment for the Reason That:
Section
Paragraph
As Amended States:
As,
1. Plot Plan Attached Showing All Existing Structures Drawn to Accurate Scale, as Well as, Proposed Structures, and All Structures on Adjacent Properties Within 50 Feet of Lot Lines.
2. Floor Plan and Elevations Attached
Has a Previous Case Been Filed Before the Board of Adjustment in Connection with This Premises?
1. Yes
2. No
If Yes, State Case Number; Date and Decision Made by Commission
If a Variance Request Is Being Made, State Specific Hardship
Give Reason for the Request and Why You Believe the Board Should Approve This Request:
I hereby certify that all foresaid statements and the statements contained in any attachments or plans submitted herewith are true to the best of my knowledge and belief. I have authorized to file the request.
Name of Authorized Representative
By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.*
1. I agree.
Electronic Signature*
Date*
Date
Fee Paid
1. Cash
2. Check
Check Number
Receipt Number
Date
Date

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1. Receive an email copy of this form.
Email address

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