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APPLICATION FORM <br /> COMPREHENSIVE 1'LAN TEXT AMENDMENT(CPTA) <br /> �. INDIAN RIVER COUNTY <br /> Planning Division accepts Comprehensive Plan Text Amendment applicatio nly`durhig' '1 <br /> the months of.lanuaty and Jul}' of eachfear•. Each application trust be c mtlete when <br /> submitted and 'Dust include all requited attachments. An incomplete applica 'ori► jvill not -. <br /> be processed and will be returned to the applicant, t:�<` <br /> Assigned Project Number: CPTA- X01 D 7 D D d — 1/35� I ` 9 7 7 <br /> Current Owner/A licant A ent <br /> I\raI]1C; / Q <br /> 12 <br /> Cor7rplete Mailing l�01 S 7/ <br /> Address: ]l�6 ��, 3296 <br /> Phone#1(including area <br /> code) (']72) 22�-- 125 <br /> Fax if(including area code) 7Z6 z2 <br /> E-Mail: .5 r-o ham; %�c ter. (onn <br /> Contactl'erson: ,�s�.,r <br /> Siguat'rt•e of Owti•uer or Agent:, ' <br /> Please attach the following items to this application. Do not ignore any of the folioNa-ing items. indicate <br /> .. "N/A"if all item is not applicable, n S <br /> 1. \Vhat Is the proposed amendment's cltatiot! in the C'o. I rehensive I lar'? htclude the element or sab- <br /> ele:nc:lt, page number, and il'applicable, the.objecliv e and police' tuunber(s). <br /> 2. �Vhzt is file exact language proposed to be added and/or deleted Ironl tilt plan,? <br /> 3- What is rhe purpose of the request? <br /> d. What is tale justification for the request? <br /> 5. Protide an analysis of the proposed amendment's consistency with all applicable foals, objecik-cs, and <br /> policies of the comprehensive plan. <br /> 6. Provide an analysis of the proposed amendment's impact on public facilities and ser.-ices. <br /> 7. Provide an analysis of the proposed amendment's environmental impacts. <br /> 8. Provide a check, money order or cash in the amount of$2.600.00, made payable to Indian River <br /> County. <br /> THE APPLICAINTT' NIUST ATTEND A PRE-APPLICATION CONFERENCE WITH LONG- <br /> 1LLN'GE PLANNING SPCTION STAFF PRIOR TO APPLYING. <br /> FiC:on:m:cui� f�c:r!opnt:n;C!sea�1'ICfU�•d'ORi.i�',C]'T.\A\11iNJ:.IEN'fFOiL'.f.dac <br /> ATTACHMENT j <br /> 175 <br />