AS OF JULY 1, 2016, A PROPERTY OWNER ACKNOWLEDGEMENT FORM MUST BE SUBMITTED WITH THE APPLICATION.

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Board of Zoning Appeals Appeal From Decision of Zoning Official Application AS OF JULY 1, 2016, A PROPERTY OWNER ACKNOWLEDGEMENT FORM MUST BE SUBMITTED WITH THE APPLICATION. ALL ONLINE APPLICATIONS ARE DUE BY 11:59 p.m. ON THE DEADLINE DATE. It is highly recommended that the property owner and/or a representative meet with staff prior to submitting an application. Nature of Request & Fees Notice of Appeal from Action of a Zoning Official $200.00 Requirements All supplemental information must be submitted in a single PDF file with this application. An accurate, legible plot plan showing property dimensions and locations of structures and improvements must be attached to an application for variance or special exception. The following supplemental information is included with this application(please list):* Please attach supplemental information outlined above:* Zoning Appeal with Exhibits.pdf Applicant Information Applicant(s)* Address:* Daytime Phone:* Email: Owner Information (if other than applicant) Owner(s): Address: Daytime Phone: Email: Property Information Stree Address:* Lot: Subdivision: Plat Book: Block: Tax Map No:* Page: Zoning District:* Designation Information (complete only if owner is not applicant) I (we) hereby appoint the person named as Applicant as my (our) agent to represent me (us) in this application. Date: Owner: Owner: 1.Applicant appeals to the Board of Zoning Appeals from the action of the Zoning Official affecting the the property described in https://www.tompsc.com/admin/formhistory.aspx?sid=21576[3/2/2018 2:57:49 PM]

the Notice of Appeal on the grounds Granting or Denial (indicate below) * Granting Denial of an application for a permit to: was erroneous and contrary to provisions of Zoning Code Section: OR Applicant hereby appeals to the Board of Zoning Appeals from the following action or decision of the Zoning Official: which was erroneous and contrary to provisions of Zoning Code Section: 2. Applicant is aggrieved by the action or decision in that: 3. Applicant contends that the correct interpretation of the particular Zoning Code Section is: 4. Applicant requests the following relief: Development Approval Application (Permit) Recorded Convenant Affidavit I, the undersigned, serve as the owner and/or owner's representative and certify that the information contained herein to be true and accurate. I further certify that the tract(s) or parcel(s) of land to which this approval request pertains:* Is Restricted Is Not Restricted by any recorded covenant that is contrary to, conflicts with, or prohibits the activity for which approval is sought as provided in SC Code of Laws Section 6-29-1145, and the Town of Mount Pleasant Code of Ordinances 155.084 and 156.048. Electronic Signature certify that I am the owner or serve as the owner s representative and am duly authorized to complete this application. I certify that all information required for review of this submittal is included. If an application is found to be incomplete, the primary contact will be notified and the application removed from the agenda.* I understand that selecting the box below will serve as my electronic signature.* I agree Information of person completing electronic signature https://www.tompsc.com/admin/formhistory.aspx?sid=21576[3/2/2018 2:57:49 PM]

Name:* Address (if different from above): Email: Date: Phone:* PROPERTY OWNER ACKNOWLEDGEMENT FORM Please upload this form containing the original signature of the property owner, which verifies the applicant is acting with the owner's permission. * Property owner acknowledgement form_5.pdf * indicates required fields. https://www.tompsc.com/admin/formhistory.aspx?sid=21576[3/2/2018 2:57:49 PM]