Planning | 2019
Application # ____________
CERTIFICATE OF ZONING PLAN APPROVAL
A Certicate of Zoning Plan Approval (CZPA) is required for accessory structures, fences, patios, walls, temporary signs, model homes,
outdoor sales, and for all commercial projects.
I. APPLICATION REQUIREMENTS
APPLICATION FEE ($85 RESIDENTIAL, $165 COMMERCIAL, $90 TEMPORARY SIGN, $0 IF SUBMITTED AS
A PART OF AN APPLICATION FOR A SITE OR BUILDING PERMIT)
SCALED SITE PLAN
One (1) copy, indicating all current structures, property lines, setbacks, and easements in addition to all proposed structures
and site improvements. All proposed work should be dimensioned and labeled. Additional documentation may be required.
Partial or incomplete applications and drawings cannot be processed and will be returned to the applicant. Typically,
site plans come from the mortgage survey and are enclosed with the closing papers, these may be used as a reference.
III. PROPERTY & APPLICANT INFORMATION
Describe the proposal (patio, fence, temp. sign, etc.):
Describe the use of the property (residential, commercial, etc.):
IV. APPLICANT’S STATEMENT OF ACKNOWLEDGEMENT: This section is NOT required for temporary signs.
Address of Subject Property OR Parcel ID:
Property Owner: Phone Number:
Subdivision/Business Name: Lot Number:
Address of Applicant/Authorized Representative:
Applicant’s Phone Number: Applicant’s Email:
I, _______________________________________ , the owner and applicant, hereby authorize _______________________________
to act as my representative and agent in matters pertaining to the processing and approval of this application including
modifying the project, and I agree to be bound by all representations and agreements made by the Authorized Representative.
Property Owner Signature: Date:
Authorized Representative Signature: Date:
FOR CITY USE ONLY
Approved Approved as Noted Disapproved as Noted Issued By: Date:
This Certicate of Zoning Plan Approval is issued for, and in reference to the property and use described above, and as approved by the City Administrator or designee, or
the City Council, Board of Zoning Appeals, Planning & Zoning Commission, or the Architectural Review Board as appropriate.
For questions or more information, please contact Planning at 614.410.4600 ׀ www.dublinohioUSA.gov