Fill and Sign the Application for Employment City of Sebastian Form

CITY OF APPLICATION FOR CONDITIONAL USE Please provide all of the following information and return to: 1. Official 911 address or legal description: _____________________________________________________________________________________ _____________________________________________________________________________________. 2 Property Appraiser parcel #: _____________________________________________________________ 3. Total acres (or square feet) to be considered as part of this request: ______________________________ 4. The names and addresses of all owners as shown in the Putnam County public records:__________________________________________________________________________________________________________________________________________________________________________ 5. Current zoning designation: _________________ 6. Number and types of structures on the property: __________________________________________________________________________________________________________________________________ 7. Conditional use requested: ______________________________________________________________ 8. Copy of recorded deed (attach to application). 9. Boundary survey or location map (attach to application). 10. Site plan(s) at an appropriate scale showing: proposed placement of structures on the property provisions for ingress, egress, and parking loading, refuse, and service areas required yards and other open spaces proposed locations for utilities connection screening and buffering with reference as to type, dimension, and character landscaping and tree protection signs and lighting, including type, dimension, and character. any additional restrictions placed on conditional use. 11. Name, telephone number, and mailing address of agent authorized to represent owner (if applicable): _____________________________________________________________________________________________________________________________________________________________ 12. Eighty-five dollar ($85.00) application fee (checks payable to City of ). 13. This application submitted by: Signature of owner(s): ________________________ _______________________ Print owner(s) name(s): _______________________ _______________________ Address of owner(s): _________________________ _________________________________________________________________ _______________________ Telephone: _______________________ _________________________________ STATE OF County of Before me this day personally appeared _______________________________ who executed the foregoing application and acknowledged to and before me that ______ executed said instrument for the purposes therein expressed. WITNESS my hand and official seal, this ______ day of ______________ A.D. 20___. ______________________________ Notary Public My commission expires: State of at Large