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