Map Request Form

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AERIAL/ZONING REQUEST FORM

Town Seal

Please use the form below to request an aerial/zoning map from the Town of Brookhaven Planning Department. Documents will be provided electronically.

YOUR INFORMATION

Your First Name*

Your Last Name*

Your Phone Number*

###-###-####

Your Email Address*

Your requested documents and receipt will be sent to this email address.

Your Company

REQUEST INFORMATION

I would like an aerial photograph.

I would like a Town Based Zoning Map.

Suffolk County Tax Map Number (must be 19 numbers)*

Project Name

Project Address

Notes

PAYMENT INFORMATION

Payment Type*

Credit Card
e-Check

I attest that I have read and approve the Town of Brookhaven Online Payment Terms and Conditions*

Yes

Map Fee:

Convenience Fee:

Total Amount Charged:

Subtotal

Credit Card Convenience Fee

Total Cost

Payment ID

Prove You Are a Human*

xdata_1*

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