UDO Administrative Manual - Currituck County Government

Use PermitApplicationOFFICIAL USE ONLY:Case Number:Date Filed:Gate Keeper:Amount Paid:Contact InformationAPPLICANT:Name:Address:PROPERTY OWNER:Name:Address:Telephone:E-Mail Address:Telephone:E-Mail Address:LEGAL RELATIONSHIP OF APPLICANT TO PROPERTY OWNER:Property InformationPhysical Street Address: ___Location: _______Parcel Identification Number(s): ____Total Parcel(s) Acreage: __Existing Land Use of Property:RequestProject Name:Proposed Use of the Property:Deed Book/Page Number and/or Plat Cabinet/Slide Number:Total square footage of land disturbance activity:_______Total lot coverage: Total vehicular use area: ______Existing gross floor area:Proposed gross floor area:Community MeetingDate Meeting Held: _________________ Meeting Location: ______Administrative ManualPage 2.137Use Permit ApplicationPage 5 of 9