Zoning Application Form

ZONING APPLICATION FORM

Application Date:    Application No.:

Applicant Information

Owner    Agent/Representative    Other (specify):

Property Identification

Property Address:

Parcel / APN:    Lot/Block:

Project Description

Zoning Relief Requested

Rezoning / Map Amendment    Variance from Zoning Standards    Conditional Use Permit    Site Plan Review    Temporary Use Permit    Other:

Disclosures

Historic Property: Yes    No     Floodplain/Wetlands: Yes    No     Known Hazardous Materials: Yes    No

Prior Code Enforcement or Zoning Violations on Subject Property: Yes    No     If yes, describe:

Attachments Checklist

Please indicate the documents included with this application:

Site Plan / Survey    Floor Plans    Landscape Plan

Traffic Study    Environmental / Phase I Study    Owner Authorization

Other attachments (identify):

Fees

Payment Method:    Fees are non-refundable except as required by applicable ordinance.

Certification and Authorization

By signing below, the Applicant certifies under penalty of law that the information contained in this application and accompanying documents is true and accurate to the best of the Applicant's knowledge. The Applicant authorizes municipal staff and designated agents to enter the subject property at reasonable times for the purpose of inspection, measurement, or photographing in connection with this application. Applicant understands that submission of incomplete or false information may result in denial of the application or revocation of any approval granted.

The Applicant agrees to defend, indemnify, and hold harmless the municipality and its officers, employees, and agents from liabilities, claims, damages, and costs (including reasonable attorneys' fees) arising directly from Applicant's failure to comply with conditions of approval or from actions by third parties arising out of the proposed development, except to the extent caused by the municipality's gross negligence or willful misconduct.

Administrative Use Only

Hearing Date:    Decision Date:    Staff Reviewer:

Notices

Submission of this application does not constitute approval. Approvals are effective only when issued in writing by the authorized municipal official. Any approval granted is subject to compliance with all applicable local ordinances, conditions of approval, and applicable state and federal laws. Applicant is responsible for obtaining any required permits and for compliance with conditions of approval prior to commencing construction or use.

False statements made in this application may subject the Applicant to penalties under applicable law, including fines and revocation of approvals.

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