ALL APPLICABLE SECTIONS OF THIS APPLICATION MUST BE COMPLETE AND THE INFORMATION CONTAINED HEREIN MUST BE CONSISTENT WITH ALL MATERIALS, PLANS AND DRAWINGS SUBMITTED.

This form must be notarized and cannot be submitted electronically.

  1. You can fill out the form online and print it.
  2. You can download the PDF and fill out it.
  3. You can contact Earl Bradfield at 314.513.5013 and obtain a fillable document.

Click to download PDF version of form.

Special Land Use Permit Transfer

  • Full name of party with Legal Interest (i.e.: Corp., Partnership, Proprietor, etc.)
  • , the Applicant, and states they have the following legal interest in the tract of land, located in the City of Hazelwood, State of Missouri, as described below:
  • Parties of Interest

  • i.e. Corp, Officer, Partner
  • i.e.: Architect, Engineer, Attorney
  • Request

    The applicant requests a Special Land Use Permit transfer/amendment for the following reason(s) which have been deemed by the Public Works Director to be minor changes to the original permit and will not affect the intensity of use:
  • Two Original Applications with Notarized Signature Two Copies of a Document Proving Legal Interest (i.e.: Deed, Lease, Sales Contract) Two Copies of Registration Certificate for Business names from Secretary of State. If Ownership Change - Signed Letter from the Current Special Land Use Permit Holder Relinquishing the Permit to the Applicant