Zone Change/Planned District
Amendment/Site Plan Approval
Project Number:
Case Number:
Street Address:
Legal
Description
Lot: Block:
Subdivision:
Submittal and Fees
Items to be submitted with this application form:
Application Fee Payable to the ‘City of Midland
Dimensioned Site Plan
Digital Copies of Site Plan (PDF/JPEG)
Applicant (if acting as Agent, see affidavit on page 2)
Printed Name:
Phone ( )
Email
Address
City
State
Zip
Property Owner
Printed Name:
Phone ( )
Email
Address
City
State
Zip
Representative (if different from Applicant or Property Owner)
Firm:
Printed Name:
Phone ( )
Email
Address
City
State
Zip
Current Zoning:
Proposed Zone:
(List by tracts if more than one district is requested)
Reason for Zone Change Request:
Present Use of Property:
Proposed Use of Property:
How would this zone change affect the public health, safety and welfare?
Describe how conditions affecting the property have changed since present zoning
designation:
Signature (by property owner onlyauthorized agent must sign affidavit below)
Applicant (signature): Date:
Applicant (printed):
Property Owner (signature): Date:
Property Owner (printed) :
The Zone Change/Planned District Amendment/Site Plan Approval shall be considered officially received in the Planning
office only when it has been submitted in full compliance with the provisions of Section 212 of the Texas Local
Government Code and the Zoning Code of Ordinances of the City of Midland and when such required items for the
application are also received.
All materials, including exhibits, submitted in support of an application, or displayed during a public hearing, shall remain
the property of the City of Midland.
STATE OF TEXAS
COUNTY OF MIDLAND
Before me, the undersigned authority, on this day personally appear who, being by
me duly
sworn, upon oath says: That (s)he is the owner of _____________________or authorized by __________________, the
owner of the above
described property, to fully represent him/her in this application and that (s)he had the legal right,
power and authority to
sign said owner’s name hereto as his/her attorney in fact.
Authorized Agent (signature)
Subscribed and sworn to before me, this day of _, 20 , to certify which witness
my hand and seal of office.
NOTARY PUBLIC, MIDLAND COUNTY, TEXAS
FOR OFFICE USE ONLY
Property Owner Authorization
Dimensioned Site Plan
Application Fee
Plans in Digital Format (PDF/JPEG)
Check #_
Received By: Date:
**Application will not be considered for scheduling until reviewed by a planner.**
Special Exception Application
2
Revised 12/6/16