City of Washington
Department of Planning and Development
Application for an Administrative Hearing
Page 1: Applicant Information & Statement
Date: Fee:
Applicant:
Address:
Phone No.:
TO THE BOARD OF ADJUSTMENT:
I, _______________________________________________,
   (Name of Applicant)
hereby appeal to the Board of Adjustment from the following adverse decision of a Zoning Enforcement Officer of the Planning Office:
The adverse decision was made with respect to property located at:
_________________________________________________
(Street Address)
Parcel Tax Card No.:

I, _____________________________________, hereby request an interpretation of:

(   ) the Zoning Map
(   ) the following section(s) of the text of the Zoning Ordinance:
_______________________________________________

insofar as the map and/or the ordinance relate to the use of the above described property.
Continue to Page 2 of the Administrative Hearing Application
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