Developer Information Development Company State of Incorporation State of Incorporation - Select -AlabamaAlaskaAmerican SamoaArizonaArkansasArmed Forces (Canada, Europe, Africa, or Middle East)Armed Forces AmericasArmed Forces PacificCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFederate States of MicronesiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming Address Address Address 2 City/Town State/Province - Select -AlabamaAlaskaAmerican SamoaArizonaArkansasArmed Forces (Canada, Europe, Africa, or Middle East)Armed Forces AmericasArmed Forces PacificCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFederate States of MicronesiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming ZIP/Postal Code Telephone Fax Contact Person Name Title Office Phone Cell Phone Email Address Development Information Name of Development Location (Address or Cross Streets) Residential Units: Single- or Two-Family, or Townhomes ($1,087.00 per unit) Residential Units: Multi-Family or Townhomes ($692.00 per unit) Non-Residential Uses ($0.60 per square foot) Non-Residential: Total Square Feet Impact Fee Determination Impact Fee Determination - Select -No impact fee owedImpact fee owed in the amount of: Enter Amount Here If applicable: The Applicant desires to make an in-kind contribution in lieu of paying all or a portion of the impact fee owed. Description of the in-kind contribution (attach additional information if necessary) and amount of impact fee off-set: By checking this box, the developer is electronically signing this Impact Fee Form with the other documentation required by the Town as part of its development permit application process. If the Town denies the application, the developer is not required to pay the Impact fee or make an In-Kind Contribution to the District. If the Town grants the application and issues a development permit, the developer must pay the Impact Fee and/or make the In-Kind Contribution, or enter into a written agreement with the District to make the In-Kind Contribution before the Town will issue a Certificate of Occupancy in connection with the development. Submit
