Bessemer City Zoning Code

City of Bessemer

Application for Resurvey Plat

Date ___________

Name of Subdivision ___________

Name of Applicant ___________

Owner of Record ___________

Surveyor ___________

Property Address ______________________

Parcel Identification Number ___________

Previous Subdivision Name ___________

__________________

Lot Numbers (Attach Plat Map of Original Subdivision)_______

Existing Parcel Zoning ___________

Name of Applicant ___________

Will The Property Require Rezoning? ___YES ___NO

Proposed Zoning ___________

Will Public Improvements be Required by Resurvey? ___YES ___NO

___ Attach five (5) copies of resurvey plat.

I, ___________ hereby depose and say that all the above statements and the statements contained in the papers submitted herewith are true.

Signature ______________________ Title ___________

Address___________ City_______ State_____ Zip Code_____