Fax
State Zip
Fax
City of Greenacres
Application for Variance
Instructions to Applicant:
Answer all questions completely.
A filing fee in the amount of $220.00 and advertising fees in the amount of $200.00 for Residential Uses
OR $550.00 and advertising fees in the amount of $200.00 for Non-Residential Uses must accompany this
application. Since advertising costs vary, the final amount will be reconciled upon receipt of invoice
from the newspaper.Provide required attachments (warranty deed, survey and plans) as shown on the
attached checklist.
Provide required attachments (warranty deed, survey, list of property owners and plans) as shown on t he
attached checklist.
Project Name
Agent’s Name
Address
City State Zip
Phone
Email
Owner’s Name
Address
City State Zip
Phone Fax
Email
Correspondence Address: (If different than agent or owner)
Address
City
Phone
Email
This is the address to which all agendas, letters and other materials will be forwarded.
Site Address
Parcel Identification Number(s)
Property Size (Square feet/Acres)
Existing Use of Property
Existing Zoning of Property
A Variance is requested from Article , Section
of the City of Greenacres Zoning Regulations.
Describe Variance Requested.
Petitioner’s Statement: (Explanation, extent and nature of your request) Provide attachments
as necessary.
Applicant’s Statement of Justification: (Attach additional sheets as necessary).
The applicant is to explain how the request conforms to the following findings:
A. That special conditions and circumstances exist which are peculiar to the land, structure, or
building involved and which are not applicable to other lands, structures, or buildings in the
same district.
2
B. That special conditions and circumstances do not result from the actions of the applicant.
C. That granting the variance request will not confer on the applicant any special privilege that
is denied by the Zoning Code to the other lands, buildings or structures in the same zoning
district.
D. That literal interpretation of the provisions of the Zoning Code would deprive the applicant of
rights commonly enjoyed by other properties in the same district under the terms of this
Zoning Code.
E. That the variance granted is the minimum variance that will make possible the reasonable
use of the land, building or structure.
3
20
The Applicant Affirm and Certify that the information supplied on this Application is
complete and accurate, and that the request for Variance, if approved, will be completed
and the premises used as stipulated by the Zoning Board of Adjustments and Appeals
regarding this request.
Signature of Applicant or Agent Print Name
OWNER (If other than above):
I have read and familiarized myself with the con tents of this application and do hereby consent to it being
submitted and processed. If owner using an agent, please use attached form.
Signature of Owner(s) of Record Print Name
Sworn to and subscribed before me this day of by who
is personally known to me, or who has produced as identification.
Signature of Notary Public Print Name
Notary Public State of County of
Commission Number Commission Expires
Notary Seal
(Print, Type, or Stamp Commissioned Name of Notary Public)
4
click to sign
signature
click to edit
click to sign
signature
click to edit
click to sign
signature
click to edit
as identification
Agent Authorization Form
City of Greenacres
I hereby give AUTHORIZATION to
to act on my behalf, to submit or have submitted this application and all required material and
documents, and to attend and represent me at all meetings and public hearings pertaining to the
application(s) indicated above. Furthermore, I hereby give consent to the party designated
above to agree to all terms and conditions, which may arise as part of the approval of this
application for the proposed use of
Applicant Information
Signature Print Name
Address City State Zip
Agent Information:
Signature Print Name
Address City State Zip
Notary Public Information:
The foregoing instrument was acknowledged before me this day
of 20 by Name of person acknowledging. He or she is
personally known to me, or who has produced
(type of identification and did or did not take an oath (circle correct response).
Signature of Notary Public Print Name
Notary Public State of County of
Commission Number Commission Expires
Notary Seal or Stamp
5
click to sign
signature
click to edit
click to sign
signature
click to edit
click to sign
signature
click to edit
who
as identification.
Print Name
Affidavit
State of Florida
County of Palm Beach
City of Greenacres
Before me this day personally appeared who being duly
sworn, deposes and says:
That the accompany list of property owners, mailing addresses and legal
descriptions of all property w ithin 300 feet of the below described parcel of land
is, to the best of his or her knowledge, complete and accurate as recorded in the
latest official tax rolls in the Palm Beach County Courthouse.
The subject Property is Legally described as follows. See attached.
Further Affiant sayeth not.
Signature
Sworn to and subscribed before me this day of 20 by
is personally known to me, or who has produced
Signature of Notary Public
Commission Number Commission Expires
Notary Seal
(Print, Type, or Stamp Commissioned Name of Notary Public)
6
click to sign
signature
click to edit
click to sign
signature
click to edit
Variance Submittal Checklist
GENERAL REQUIREMENTS
1. Application Review Fee and Advertising Fee.
2. Completed application signed by owner and applicant. Agent’s authorization
or power of attorney must be attached if applicant is other than owner.
3. Copy of the Warranty Deed.
4. Survey, signed and sealed, (not more than a year old) and legal description of
the property, including any and all easements of record (referenced by Official
Records (OR) Book and page) prepared by a surveyor registered in the State of
Florida.
a. Submit seven (7) copies 24” x 36”, one (1) set 11” x 17”, and one (1)
Electronic Digital Copy.
5. A list of all property owners within a three hundred (300) foot radius of boundary
lines of the subject property and a vicinity map delineating the proposed area and
its boundaries from the most recent tax roll information as provided by the Palm
Beach County Appraiser’s Office.
6. Executed affidavit signed by the person responsible for completing the property
owner list.
7. One (1) set of STAMPED (meter stamps not acceptable), plain envelopes with
the typed names of the owners within a 300’ radius of the boundary lines of the
subject property. No return address.