An application has been filed by ____________________ (name of applicant) for a ______________________ (variance, exception, special use permit) to permit _____________________ (purpose for zoning request) at ________________ (address) in the City of _________________ (city), Country of ______________ (county), State of __________________ (state).

The property in question is presently zoned for ____________ (zoning) , and the adjacent property is _______________ (zoning).

As property owners in the area, the undersigned do hereby request that the pending application mentioned herein be denied by the _________________ (name of commission) on the following grounds: _______________________________________________________________________________________________

(Grounds for petition)