APPENDIX D#
CITY OF CORTEZ APPLICATION FOR ZONING ACTION#
This application is for:
- ☐ Conditional Use Permit
- ☐ Special Exception
- ☐ Right-Of-Way or Easement Vacation
- ☐ Site Plan Review
- ☐ Replat or Plat Amendment
- ☐ Variance
- ☐ Condominium Subdivision/Conversion
- ☐ Minor Subdivision
1. APPLICANT SHALL COMPLETE:#
| Item | Information |
|---|---|
| Property Owner | |
| Mailing Address | |
| Phone | |
| Subject Property Street Address | |
| Legal Description; or ☐ Attached | |
| Existing Use(s) | |
| Proposed Use(s) | |
| Square Footage | |
| Lot Coverage (%) | |
| Lot Size | |
| Proposed Building Height | |
| Off-Street Parking Spaces | |
| Proposed Setbacks: Front / Side / Rear | |
| Public Works Department Approval? | |
| Sanitation District Approval? |
Oath of Applicant#
I hereby certify, subject to penalty of perjury, that the above is true and accurate to the best of my knowledge and that I understand all provisions of City and State codes applicable to the proposed development, any and all conditions placed upon the proposed development by the City Council and all information requested by this document. I also understand that if I violate any applicable provisions of City and/or State codes, I may be required to remedy such violation(s) through appropriate legal process imposed by the City, including moving or removing structures and ceasing of construction and/or uses.
| Signature of Applicant | Date |
2. APPLICANT SHALL ATTACH ___ COPIES OF A COMPLETE SITE AND ACCESS PLAN OR PLAT SHOWING THE BUILDING OR STRUCTURE IN SUFFICIENT DETAIL TO DEMONSTRATE THAT THE PROPOSED CONSTRUCTION, RECONSTRUCTION OR CONVERSION, MOVING AND/OR ALTERATION IS IN CONFORMANCE WITH THE PROVISIONS OF THE APPLICABLE ACTION.#
Other Items Required:
3. ZONING ADMINISTRATOR SHALL VERIFY COMPLIANCE WITH:#
| Item | Verification |
|---|---|
| Application Completeness | ___________ (If incomplete, return to Applicant) |
| Zoning | _______ Conditional Use Permit # ___________ |
| Floodplain Development Permit # | _______ Board of Adjustment Resolution # |
List Conditions of Approval or Attached:
Should Bldg. Permit Application Be Considered?
YES_______
NO_______
Comments:
| Signature of Zoning Administrator | Date |
4. BUILDING OFFICIAL SHALL VERIFY COMPLIANCE WITH:#
| Item | Verification |
|---|---|
| Use | _____ |
| Height | _____ |
| Setbacks | _____ |
| Access | _____ |
| Driveway width | _____ |
| Parking Spaces | _____ |
| Water Supply | _____ |
| Sanitation | _____ |
Can Bldg. Permit Be Applied For?
YES_______
NO_______
Comments:
| Signature of Building Official | Date |
5. IF THE BUILDING OFFICIAL SO AUTHORIZES, APPLICATION(S) FOR A BUILDING PERMIT THAT CONFORM MATERIALLY WITH ALL INFORMATION PROVIDED ABOVE MAY BE SUBMITTED TO THE BUILDING DEPARTMENT.#
For Official Use Only:#
| Item | Date |
|---|---|
| Date Received | _____ |
| Date Of Public Hearing(s) | _____ |
| Date Of Approval | _____ |