TOWN OF BERMUDA RUN  120 Kinderton. Blvd., Suite 100* Bermuda Run, NC 27006 Phone 336-998-0906* Fax. 336-998-7209 Land Development Application-Please, fill out completely, or application will not bey processed.  (updated 1/10/13)  Case #: Board Review Items: Rezoning (Map Amendment) Standard Rezoning Conditional District Rezoning Text Amendment Special Usel Permit Design Waiver: Other:_  1. Application Type Subdivision: Major Subdivision Sketch Plan Preliminary Plat Construction Plans Final Plat Minor, Subdivision Final Plat Sitel Plans: Level II Sitel Plan  J Fee D D D a D  Fee Total  / Fee 0 D D D D D  2. Project Information Date of Application Location Current Zoning Current Land Use Tax] Parcel Number(s) 3. Contact Information Developer Developer Address Telephone Signature  Name of] Project  Phaset #  Property Size (acres) Proposed. Zoning Proposed Land Use_  #ofUnits (residential).  City, State Zip Fax  Print] Name  Date  Agent (Registered Engineer, Designer, Surveyor, etc.)  Property Owner Address City, State Zip Telephone Signature Pagelof2  Address City, State Zip Telephone Signature  Fax Print] Name Date  Fax  Print Name  Date    4. Description of] Project  a. Briefly explain the nature oft this request:  b. For All Text Amendments: State the section(s) of the Zoning or Subdivision Ordinance you wish to amend and attach the c.For AIl Rezonings and' Text Amendments: Provide a statement: regarding the consistency oft this request with the  proposed text change. Section (s):  ofthe_  Ordinance.  Comprehensive Plan and the surrounding land uses.  d. For Conditional. District Rezonings: Provide a statement regarding the reasonableness of thei rezoning request.  .For Special Use Permits: Please alsoi fill out the supplemental form for Special Usel Permits.  Staff Use Only:  Date Application Received: Received By: Fee Paid: $ Case #: Notes:  Page 2 of2