T:\CD\PLANNING\FORMS\Planning Application Forms\Planning Application Form updated 4-29-19.doc
Property Address: ___________________________ Property Owner: ____________________________
_____________________________ Address: ________________________
Assessor’s Map & Tax Lot: ____________________________________________
____-____-____-____ Tax Lot(s) _______________ Phone: ______________________________________
____-____-____-____ Tax Lot(s) _______________ Email: _______________________________________
Zoning: ____________________ Applicant: _____________________________
City: UGB: Address: _____________________________________
_____________________________________________
Phone: _______________________________________
Email: ________________________________________
Authorized Representative (if different from applicant):
______________________________________________
Address: ______________________________________
Phone: _______________________________________
Email: ________________________________________
Surveyor or Engineer (if applicable):
_______________________________________
Address: ______________________________________
Phone: ________________________________________
Email: ________________________________________
CERTIFICATION: I hereby certify that the information on this
application is correct and that I own the property, or the owner has
executed a Power of Attorney authorizing me to pursue this application
(attached).
_______________________________________________
(Signature of owner or Attorney-in-Fact) Date
_______________________________________________
(Signature of owner or Attorney-in-Fact) Date
Project Type: (Please check all applicable)
❑ Site Plan
❑ Standard Architectural Review
❑ Discretionary Arch. Review
❑ Special Concept Plan
❑ Partition
❑ Property Line Adjustment
❑ Property Line Vacation
❑ Planned Unit Development
❑ Subdivision
❑ Final Subdivision or PUD Plat
❑ Variance
❑ Comp Plan/Zone Map Amendment
❑ Text Amendment
❑ Pre-Application
❑ Appeal / Sign Code Appeal
❑ Other: ____________________________
Size of Project (# of units, lots, sq. ft., etc):
___________________________________________
Attachments:
❑ (8) Folded Maps/Site Plan to scale
❑ (1) 8 ½ x 11” reduced copy of site plan
❑ Electronic copy
❑ Written Narrative/Response to Criteria
❑ Power of Attorney
❑ Service Agreement
❑ Architectural Features
❑ Other: ______________________________
Description of Request
(include name of project and proposed uses):
_______________________________________
_______________________________________
_______________________________________
_______________________________________
(For Office Use)
Date Application Received: ____________________________
Date Application Complete: ____________________________
Pre-App required? Y N Pre-App #____________________
Fees Paid: _________________________ Initials: __________
File Number(s): ______________________________________
Planner
