HONORARY STREET NAME APPLICATION

Transcription

1 HONORARY STREET NAME APPLICATION City Planning & Development Department City Hall, 414 E. 12 th Street, 15 th floor; Kansas City, MO Phone (816) Fax (816) Date Stamp 1. APPLICANT INFORMATION Applicant s Name Organization or Company Street Address City/ State Zip Telephone ( ) Fax ( ) ( ) 2. HONORARY OR HISTORIC STREET NAME REQUEST Street name requested (indicate Honorary or Historic ): Location of proposed designation: (For example, Woodland Avenue from 36 th Street to 38 th Street) 3. REQUIRED SUBMITTALS Please submit the following items along with your request: Z A typed statement containing no fewer than 500 words describing the significance of the person, place or event being honored. The statement should indicate why a particular section of street has been requested for the honorary designation. A petition of support for the proposed honorary or historic designation being requested. Said application should be signed by no fewer than fifty (50) residents of the City of Kansas City, Missouri. The signatures of seventy-five (75) percent of the property owners on the section of street being requested for the honor should also be obtained. Special circumstances regarding street segment length or location, etc. will be considered by the Street Naming Committee on a case by case basis. The petition should be witnessed by one individual, and be notarized prior to submittal. (Note: Applicants are encouraged to contact the appropriate neighborhood association for the location of the street. Neighborhood association information is available from the Neighborhood and Community Services Department at (816) Upon submission of this application, please allow four to six weeks for staff to review your request with the Street Naming Committee. Upon completion of the Committee s review, a letter will be sent to the applicant indicating the decision of the Committee. If recommended for approval, the letter will also contain information regarding the cost to the applicant of fabrication and installation of the honorary street name signs per the applicant s request. 5. SIGNATURE OF APPLICANT: My application consists of the following items necessary for a complete application. Please check: Completed Application Form, Plus One Copy, plus a $130 fee (make checks payable to City Treasurer ) Typed statement regarding the person, place or event being honored. Petition of support for honorary street name designation request. : Date: Printed Name: UPDATED MARCH 2015

2 HONORARY STREET NAME PETITION OF SUPPORT Adjacent Property Owners Honorary Street Name requests require the signatures of seventy-five (75) percent of the property owners on the section of the street being requested for the honor. Please use the petition below to collect signatures, attach additional sheets if required. These signatures must be witnessed by a single individual and notarized. By signing this petition I am showing support for the following Honorary Street Name: Street proposed for Honorary Designation from would begin to would end Property Owner(s) (Print Name) Address (only one required per property) The undersigned, having been duly sworn and under oath, hereby states that each signature was affixed in my presence and each signature is the signature of the person it purports to be. Printed Name Subscribed and sworn to before me a notary public on this day of, 20. Notary Public My Commission expires: / /

3 HONORARY STREET NAME PETITION OF SUPPORT KCMO Residents Honorary Street Name requests require the signatures of fifty (50) residents of the City of Kansas City, Missouri. Please use the petition below to collect signatures, attach additional sheets if required. These signatures must be witnessed by a single individual and notarized. By signing this petition I am showing support for the following Honorary Street Name: Street proposed for Honorary Designation from would begin to would end Property Owner (Print Name) Address Continued on next page

4 Continued on next page

5 The undersigned, having been duly sworn and under oath, hereby states that each signature was affixed in my presence and each signature is the signature of the person it purports to be. Printed Name Subscribed and sworn to before me a notary public on this day of, 20. Notary Public My Commission expires: / /