2. Appellant Information
4. Name
6. Address
8. City
9. State
10. Zip Code
12. Phone*
13. Reply to Email:*
15. Tax Parcel Number
17. Status

    1. Property Owner

    1. Developer

    1. Other
19. Request of the Board

    1. Policy Change

    1. Policy Exception

    1. Other
21. If other, please explain.
23. Other Requests of the Board
    The Commissioners may review policy application and determinations under the following circumstances: to hear and decide appeals where it is alleged there is error in any order, requirement, decision or determination made by an administrative official in the enforcement or application of District policy; to hear and decide special exemption or general modification or revision to the terms of the policy; to authorize upon appeal in specific cases such variance from the terms of the policy as will not be contrary to public interest, where, owing to special conditions, a literal enforcement of the provisions of the policy will result in practical difficulty or unnecessary hardship, so that the spirit of the policy shall be observed.
25. Details
27. Policy at Issue
    Attach additional pages or staff report as needed
29. Additional Pages or Staff Report
31. Requested Policy Change/Exemption
    Attach additional pages if needed
33. Additional Pages
35. Electronic Signature Agreement*

    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.
37. Electronic Signature*
38. Date*
    Date
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40. 1. Receive an email copy of this form.
41. Email address

    This field is not part of the form submission.

42. Submit

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