APPLICATION FOR PUBLIC HEARING                               Case Number_________

            LEE, NEW HAMPSHIRE                                      Date Received________

                                                                                                Fee                 ________

APPLICANT:______________________________                        Clerk                _______

ADDRESS:________________________________                        Accepted            _______

                   ________________________________                    Action              _______

PHONE:     ________________________________

PURPOSE OF APPLICATION:__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

________________________________________________________________________

LOCATION AND DESCRIPTION OF PROPERTY _____________________________

________________________________________________________________________

TAX MAP NUMBER ______________________

TOTAL LAND AREA IN ACRES ____________

TOTAL ACRES IMPACTED_________________

ESTIMATED TIME FOR COMPLETION OF PROJECT:_______________________

APPLICANTS SIGNATURE:_____________________________ DATE:___________

This application must be filed with appropriate plans and information pertaining to the request, along with a list of abutting property owners with names and addresses; There will be an application fee of $90 and $8.00 for each abutter.

 The 90 day statutory deadline for action by the Lee Planning Board begins with the formal acceptance of the application which must be submitted at a public meeting, with abutting property owners notified.

Revised Fees 3/03