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Attachment C <br />INDIAN RIVER COUNTY <br />Application for Amendment of Land Use Designation <br />DATE RECEIVED: <br />APPLICANT: <br />ADDRESS: <br />nw— - <br />tL]VIVL' <br />OWNER: <br />PHONE: <br />ADDRESS: <br />EXISTING LAND USE DESIGNATION: <br />REQUESTED LAND USE DESIGNATION: <br />ACRES TO BE REDESIGNATED: <br />EXISTING USE: <br />PROPOSED USE: <br />DATE ACCEPTED: <br />The following item's must be atta hed to the application: <br />1) 'If t�6 app.licanti is 0ther''than;;�he owher (s) , a sworn° <br />statement of authorization must accompany each copy of this <br />application. <br />2) A verified statement naming every individual having legal <br />or equitable ownership in the property. <br />3) A copy of the owner's deed must accompany each copy of this <br />application. <br />4) A current owner's title policy, a certificate of title from <br />a title company, or an attorney's opinion evidencing fee <br />ownership of the property. <br />5) If the property is not located within a recorded <br />subdivision, a copy of a survey of the subject property must <br />accompany each copy of the application. This survey <br />must also indicate the location and type of all adjacent <br />land uses within 300' of the subject property. <br />Although, the surrounding uses need not be surveyed. <br />6) A check, money order or cash in the amount of $ , made <br />payable to the Indian River County Board of County Commis- <br />sioners. <br />-18- <br />