Applicant Name Sample Clauses
Applicant Name. The potential faculty advisor for a student applying to the SHRS Health and Rehabilitation Sciences MS program must check statements below, as appropriate, and sign this form.
Applicant Name. Please indicate the number of the Service Area you are applying to serve: Area ▇, ▇▇▇▇▇ ▇▇▇▇▇▇; ▇▇▇▇ ▇, ▇▇▇▇▇ ▇▇▇▇▇▇; ▇▇▇▇ ▇, ▇▇▇▇▇▇▇/▇▇▇▇ ▇▇▇▇▇▇
Applicant Name. OPA Account Number Please use the worksheet below and enter average monthly household expenses: First Mortgage Telephone Car Loan Second Mortgage Groceries (exclude Food Stamps) Car Insurance Current Year Property Taxes Clothing Car Maintenance (oil changes, repairs) Homeowner’s Insurance Laundry Transportation (gas, SEPTA) Electric Service Toiletries and Paper Goods Child Support / Alimony Gas Service Housing Allowance (People in the home x $40) Tithe/Religious Donation (not more than 10% of income) Water / Sewer Service Other Household Goods Life Insurance Oil Service Medical and Dental Expenses Other Home Maintenance Medical and Dental Insurance Other Child Support/ Alimony Prescriptions Other HOUSING SUBTOTAL $ 0 LIVING EXPENSES SUBTOTAL $ 0 LIVING EXPENSES SUBTOTAL $ 0 $ 0 Ver 20180401 Subtract expenses from your income to calculate tax payment amount
Applicant Name. Property Owner:
Applicant Name. Nombre del Aplicante: Street Address: Domicilio: Unit #: # de Unidad: City/Zip: Ciudad/Código Postal: Home Phone: Teléfono: Work or Daytime Phone: Número durante el día o del trabajo:
Applicant Name. Sr. No. Parameter Details
Applicant Name. <<<<<<<<<< MUST BE A PERSON Mailing Address: Phone #: City: State: Zip: E-Mail: OWNER INFORMATION (IF NOT SAME AS APPLICANT) Owner Name: Mailing Address: Phone #: City: State: Zip: E-Mail: REQUEST Zoning District: Property Acreage: Subject Property Location: Notes: FEES Request Type Fee: Concurrency Review Fee: Exempt from Fee REQUIRED ATTACHMENTS PAYMENTS 1. Complete Application Form 2. $7,500.00 Application Fee (Rezoning, less than 10 acres) 3. $9,000.00 Application Fee (Rezoning, 10 or more acres) 4. $5,000.00 Application Fee (MDA Amendment) 5. Letter outlining request 6. Required support documents (see attached list) 7. List of property owners within 150 feet No. Date Amount Type Ck # Balance Due: INFORMATION AND DOCUMENTS SUBMITTED ARE COMPLETE AND ACCURATE TO THE BEST OF MY KNOWLEDGE. _____________________________________________ _________________________ Signature of Property Owner and/or Applicant Date _______________________________________________ Print Above Name Note: Application and all required support documents must be submitted by 12:00pm on the submission deadline in order for application to be considered complete. completed application form; application administration fee as approved by the City Commission; two copies of a plat of survey indicting property boundaries, legal description, acreage, and limits of the jurisdictional wetlands; names and addresses of property owners within 150 feet of the affected property. This distance shall be measured in an airline at the closest points between two properties; certification from landowner of record that applicant has authorization to make application for the requested zoning action; Transportation Impact Analysis Report shall be required for any use which, according to the Institute of Transportation Engineers Trip Generation Manual, latest edition, rates published by the Florida Department of Transportation or rated documented by study and agreed to prior to use by the City Engineer, will generate in excess of 1000 trips per day. The contents of the Transportation Impact Analysis Report shall meet the requirements of Section 402.02; completed school planning and concurrency application; such additional materials, maps, studies, or reports subsequently deemed necessary by any reviewing department or agency; and