“Board of Variance Bylaw, 1982, No.-1919”

BOARD OF VARIANCE APPLICATION

Name

Mailing Address

Phone Number
reece

Address of Property

(Please ensure that this address

is marked on the property)

Legal Description

Zoning

Current Use of Property

Proposed Use of Property

Date of Purchase

Details of Refusal or Hardship

(See Second Page)

Signature of Owner