CITY OF DEWITT, IOWA …

                                           CITY OF DEWITT, IOWA
                                          REZONING REQUEST FORM

REZONING REQUEST NO. _____________________________________
BUILDING OFFICIAL
CITY OF DEWITT
CITY HALL (563) 659-3811

Legal Description of Land Proposed for Rezoning _____________________________________________
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Address of Land Proposed for Rezoning _____________________________________________________
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Existing Zoning              ______________________________________________________________
Proposed Zoning             _______________________________________________________________
Total Area (sq. ft. or ac.)  _______________________________________________________________

Petitioner                     _______________________________________________________________
Address                        _______________________________________________________________
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Phone Number                   (   ) _______________________
Interest in Land               _______________________________________________________________

Title Holder                   _______________________________________________________________
Address                        _______________________________________________________________
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Phone Number                   (    ) ________________________
Contact Person                  _______________________________________________________________
Address                         _______________________________________________________________
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Phone Number                   (   ) _________________________

Explanation of Rezoning (for Public Hearing Notice) _____________________________________________
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Signature of Petitioner        ________________________________________________________________

ATTACH FEE $100 if 10 acres of less, $200 if 10.01 acres or more, payable to City of DeWitt

Note: If petitioner is other than title holder, documentation will be required to show control of property,
e.g., accepted offer to purchase, option, etc.

Petitioner should follow the City's checklist in preparing materials in support of the rezoning.