ZONING BOARD OF ADJUSTMENT

APPLICATION FOR A SPECIAL EXCEPTION

 

 

To:  Board of Adjustment                                                                     Case No. ________

        Town of Kensington                                                                     Map ___ Lot _____

Date filed________

                                                                                                            ________________

                                                                                                     (signed)

 

Name of Applicant ____________________________________(___)_______________

                                                                                                            Phone #

Address ________________________________________________________________

 

Owner _________________________________________________________________

                                    (if same as applicant, write “same”)

Location of Property ______________________________________________________

________________________________________________________________________

________________________________________________________________________

                                    (street, number, subdivision and lot number)

 

Description of proposed use showing justification for a special exception as specified in the Land Use Ordinance, Article _____, Section _____: _________________________________________________________________

________________________________________________________________________

________________________________________________________________________

________________________________________________________________________________________________________________________________________________

 

Signed _________________________________                                           Date________

(Applicant(s))

 

NOTE: This application is not acceptable unless all required statements have been made.  Additional information may be supplied on a separate sheet if the space provided is inadequate.

The Applicant is responsible for supplying the names and addresses of all *abutters to the property concerned including the names and addresses of any Engineer, Architect, Land Surveyor or Soil Scientist whose professional seal appears on the plat and holders of Conservation, Preservation or Agricultural Preservation Restrictions per RSA 477:45. 

*For purposes of Notification: RSA 672:3-“Abutter” means any person whose property is located in NH and adjoins or is directly across the street or stream from the land under consideration…

 

The Applicant is to include addressed envelopes with addressed postal certification slips and Return Receipt cards for each of the abutters to be notified or 3 sets of labels.

 

Please List Current Abutters For Legal Notification Purposes:

 

Owners of Record

 

Name                                       Address                                   Zip Code          Map#   Lot#

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

________________________________________________________________________

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

 

______________________________________                                            ____________

Signature of Applicant(s)                                                                                   Date