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Application - Construction Board of Adjustment and Appeals City of La Vergne, Tennessee 5093 Murfreesboro Road, La Vergne, TN 37086 ♦ (615) 793-6295 Application - Construction Board of Adjustment and Appeals APPLICANT INFORMATION (Please Print or Type - Any Correspondence will be addressed to the individual.) 1. Date of Application: ________________ 2. Phone Number: ____________________ 3. Property Owner’s Name: ______________________________________________________ 4. Property Owner’s Address: ______________________________________________________ ______________________________________________________ 5. Property Location (If Different): ______________________________________________________ 6. Property Address: ______________________________________________________ ______________________________________________________ Section 1 - Appeal the Decision of the Building Official. 7. Decision of the Building Official: _____________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ (If additional space is needed, please use an additional sheet of paper.) Section 2 - Application for a Variance. 8. Type of Variance Needed: ______________________________________________________ 9. Justification for the Variance Requested: ______________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ (If additional space is needed, please use an additional sheet of paper.) ___________________________________________ Date: ____________________ Applicant Signature