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100.3683 Form of certificate.

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100.3683 Form of certificate. The form for the certificate of land use restriction required by KRS 100.3681 shall be as <br>follows: CERTIFICATE OF LAND USE RESTRICTION 1. NAME AND ADDRESS OPERTY OWNER(s) ................................................. ............................................................................. ................................................. ............................................................................. ................................................. ............................................................................. 2. ADDRESS OF PROPERTY 3. NAME OF SUBDIVISION OR DEVELOPMENT (if applicable) ................................................. ............................................................................. ................................................. ............................................................................. ................................................. ............................................................................. 4. TYPE OF RESTRICTION(s) (Check all that apply): .......Zoning Map Amendment to .....Conditional Zoning .......Zone <br> Condition .......Development Plan .....Other ..................................................... specify .......Unrecorded Subdivision Plat <br>.......Variance <br>.......Conditional Use Permit <br>5. NAME AND ADDRESS OF PLANNING COMMISSION, BOARD OF <br>ADJUSTMENT, LEGISLATIVE BODY OR FISCAL COURT WHICH <br>MAINTAINS THE ORIGINAL RECORDS CONTAINING THE RESTRICTION .................................................. <br>.................................................. <br>.................................................. <br>.................................................. <br>.................................................. <br> ............................................... Signature of Completing Official ............................................... Name and Title of Completing Official (Type or print) Effective: July 1990 <br>History: Amended 1990 Ky. Acts ch. 362, sec. 8, effective July 13, 1990. -- Created 1988 Ky. Acts ch. 30, sec. 4, effective July 15, 1988.