Public Street Name Change Application Packet Public Works Department New Development Division 175 East 200 North St. George, UT 84770 Office (435) 627-4120
Dear Applicant, This packet has been prepared to help aid you in preparing and completing the application and to meet the full requirements of the Public Street Name Change approval process. The items included in this packet have been prepared to allow your submittal to be processed and reviewed in the timeliest manner possible. The items included are o Application o Certification Form o Public Street Name Change Staff Review Approval Sheet Incomplete applications will not be accepted. The following outlined procedure below must be followed by the applicant(s) for a street name change 1. Talk to all parcel owners that abut the street and agree upon a name. 2. Fill out the first four lines of the Public Street Name Change Staff Review Approval Sheet and provide an explanation letter as listed on the application. Submit these two items to the City Surveyor at the address listed below. 3. The City Surveyor will then contact you to let you know if you can proceed. 4. If this request proceeds then please fill out the rest of the Application and obtain the signature of ALL those that abut the street using the Certification Form. Print additional forms if needed and submit to the City Surveyor for processing. Should you have any questions regarding this packet, or any processes please feel free to call the New Development Division or visit www.sgcity.org for further assistance. Thank you for your interest in the City of St. George. Sincerely, Public Works Department New Development Division City of St. George 175 East 200 North St. George, UT 84770 (435) 627-4120
APPLICATION FOR PUBLIC STREET NAME CHANGE CITY OF ST. GEORGE, UTAH TO THE CITY COUNCIL Date: I hereby request that the Street I currently reside on, which is known as (Current Street Name) This is located between the following streets: (Street one) (Street two) Be changed to the following name (Proposed Street Name) To be included with this application: Filing Fee = $200.00 Certifications (the signature sheet of ALL the parcel owners) Letter explaining the following o Express the need/reason for the street name change o What problems will the name change correct o How will the name change impact transportation, 911 responders, or other Mailing Labels a certified list of ownership of each parcel abutting the street (obtained from a title company or other entity willing to certify the names) Applicants Name: Address: City, State, Zip: Phone: e-mail: I, the undersigned applicant, being an owner of real property abutting the above-stated street hereby petition the City of St. George, to request the above-stated proposed street name change. It is understood that if this request is approved that it is my obligation to provide the new street sign panel(s) and replace the existing panel(s) already displayed on the sign pole(s). Applicants Signature April 1, 2016 Agent Name: Address: Phone:
Certification Form By signing below I hereby give my consent to change the name of the street abutting my parcel located in St. George, UT and currently known as: To be changed to: Owner Name (please print): Address: City, State, Zip: Phone: Parcel/Tax Number: Signature Owner Name (please print): Address: City, State, Zip: Phone: Parcel/Tax Number: Signature Owner Name (please print): Address: City, State, Zip: Phone: Parcel/Tax Number: Signature *This page must include all the owners of record of the parcels abutting the street. Please print this form for additional signatures as needed.
Public Street Name Change Staff Review Approval Sheet Current Street Name: Proposed Street Name: Applicant Name: Applicant Contact Information: Notices delivered to personnel on (date): Received Date Name, Department/Franchise Approval Denial Justin Grenier, Emergency Medical Dispatch Kevin Taylor, Deputy Fire Chief David Evans, GIS Administrator Dave Terry, Streets Superintendent Cameron Cutler, Public Works Director Wes Jenkins, Assistant Public Works Director Comments or concerns from those listed above: This Request was o Approved o Denied Date:
PROPERTY OWNERS LIST DECLARATION PUBLIC STREET NAME CHANGE City of St. George 175 East 200 North St. George, UT 84770 (435) 627-4000 www.sgcity.org The property owners listed identifies the owners of real properties abutting the roadway of the proposed street name change. The labels may be prepared by a Title Company, or by another approved party. A complete property owners list shall consist of the following: 1. Completed and signed declaration 2. List identifying each property owners name, mailing address, and Assessor s Parcel Number (APN) 3. Typed set of mailing labels for each property owner prepared on 8-1/2 x11 sheets of selfadhesive labels in three column format, as shown on the attached sample. All type shall be in capital letters with no punctuation or APN s. 4. Property owner map identifying all properties that abut the roadway. An example map is attached. LABELS PREPARED BY: Organization Name The attached list contains the names and addresses of all persons to whom all property is assessed, and as they appear on the most current County Assessment Roll. This list identifies all properties located within the required area of the property legally described by Assessor s Parcel Number(s). Legal Owner/Agent of property Date: *The list of property owners shall be submitted with the application.