2. 
4. To be completed by applicant:
6. Date:*
   Date:
8. Owner First Name*
9. Owner Last Name*
11. Owner Address*
13. Address of Property (if different than above)
15. City*
16. State*
17. Zip*
19. Daytime Phone Number*
20. Cell Phone Number
22. Email Address*
24. Current Use:*
26. Describe property/structure (e.g. architectural style, date of construction, condition of structure, history of structure, if known, etc.)
28. Is this a "contributing" structure?*

    1. Yes
    2. No
29. Is the property or structure listed on the National Register of Historic Places?*

    1. Yes
    2. No
31. Choose proposed action(s)*

    1. Alteractoin
    2. Addition
    3. Demolition
    4. New Construction
    5. Exterior Repairs/Maintenance (No Appearance Changes)
33. Description of the work to be performed on the property:*
35. Upload: Photographs, scaled drawings of the plans, elevations and materials to assist the Commission in deciding*
37. Architect First Name*
38. Architect Last Name*
40. Address1*
42. City*
43. State*
44. Zip*
46. Daytime Phone Number*
47. Email Address
49. Contractor First Name*
50. Contractor Last Name*
52. Address1*
54. City*
55. State*
56. Zip*
58. Daytime Phone Number*
59. Email Address
61. Is there an application relevant to this property and the subject of modifications or improvements pending or contemplated before the Board of Zoning Appeals, Planning Commission or City Council?*

    1. Yes
    2. No
63. If yes, please specify
65. Who will represent the owner at the Historic Zoning Commission meeting?

    Note: The representative needs to be present at the meeting to answer questions and should have the authority to commit the owner to make changes suggested or required by the Historic Zoning Commission. 

67. Representative First Name*
68. Representative Last Name*
70. Address1*
72. Address2
74. City*
75. State*
76. Zip*
78. Title or Relationship to Owner:*

80. Information: There will be two inspections prior to completion of the Certificate of Appropriateness. One near midway of the project and one at the completion of the project. Call 615-893-6441 at lease two working days prior to each the inspection. Upon completing the project, according to the application, the owner will receive a copy of the Certificate of Appropriateness in the mail. Please complete these forms and submit them to the Planning Department by 3:00 p.m. on the submittal date indicated on the HZC yearly calendar. Approvals for Certificates of Appropriateness allow six months to begin construction. If work has not commenced with that timeframe, the approval will be expired. 

82. SIGNATURE OF OWNER:*
83. ELECTRONIC SIGNATURE:*

    Electronic Signature Agreement:
    By clicking the "I agree" box, you agree and acknowledge that (1) your application will not be signed in the sense of a traditional paper document, (2) by signing in this alternate manner, you authorize your signature to be valid and binding upon you to the same force and effect as a handwritten signature, and (3) you may still be required to provide a traditional signature at a later date.

84. SIGNATURE OF AGENT:

    (When Applicable)

88. For Office Use Only:
90. Date Received:
91. Receipt #:
92. Amount Paid:
93. HZC #:
Leave This Blank:


95. 1. Receive an email copy of this form.
96. Email address

    This field is not part of the form submission.

97. Submit

* indicates a required field