City of Washington
Department of Planning and Development
Application for a Special Use Permit

Page 1: Applicant Information
Date:
Fee is $125.00              Date paid:
Applicant Name:
Address:
Phone Number:
Location of Proposed Special Use:
Purpose of Special Use:
Reason for Special Use:
Property Zoned:                                                       (  ) City     (  ) ETJ
Authority to grant the requested special use is contained in the
Zoning Ordinance, Section:
Parcel Tax Card #
To be completed by Applicant and returned no later than the fifteenth (15th) day of the month before the month in which the request will be heard by the Board of Adjustment.
Continue to Page 2 of the Special Use Permit Application
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