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Application for Future Land Use Amendment and/or Zoning Amendment

  1. Request

  2. (Acres)

  3. Adjacent Property

  4. North

  5. Choose One

  6. East

  7. Choose One

  8. South

  9. Choose One

  10. West

  11. Choose One

  12. FLU Amendment

  13. Zoning Amendment

  14. Select either YES or NO if the following public improvement(s) are available either on or adjacent to the subject property

  15. Paved Street Meeting City Standards

  16. Curb and Gutter

  17. Water

  18. Stormwater Drainage

  19. Street Lights

  20. Underwriter Approve Fire Hydrant

  21. Sewer

  22. Print Name

  23. I (We), the undersigned owner(s) for the Future Land Use and/or Zoning Amendment of the above described property in the City of Apopka, Florida, do hereby agree to Indemnify and Hold Harmless the City of Apopka, Florida, its elected officials, officers, agents, and assigns for any and all damages, attorney fees and costs incurred by said City in any instance in which the City must expend funds and/or defend its decisions regarding the granting of the above referenced application.

  24. (Signature)

  25. (Print Name)

  26. (Signature)

  27. (Print Name)

  28. (Date)

  29. (Name)

  30. (Signature)

  31. (Print Name)

  32. Leave This Blank:

  33. This field is not part of the form submission.