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City of Newport
Land Use Application
Applicant Name(s): Property Owner Name(s)
if other than applicant
Applicant Mailing Address:
Property Owner Mailing Address:
Applicant Phone No.
Property Owner Phone No.
Applicant Email
Property Owner Email
Authorized Representative(s): Person authorized to submit and act on this application on applicant’s behalf
Authorized Representative Mailing Address:
Authorized Representative Telephone No.
Authorized Representative Email.
Project Information
Property Location: Street name if address # not assigned
Tax Assessor’s Map No.:
Tax Lot(s):
Zone Designation: Legal Description: Add additional sheets if necessary
Comp.Plan Designation:
Brief description of Land Use Request(s):
Examples:
1. Move north property line 5 feet south
2. Variance of 2 feet from the required 15-foot
front yard setback
Existing Structures: if any
Topography and Vegetation:
Application Type (please check all that apply)
Annexation
Appeal
Comp Plan/Map Amendment
Conditional Use Permit
PC
Staff
Design Review
Geologic Permit
Interpretation
Minor Replat
Partition
Planned Development
Property Line Adjustment
Shoreland Impact
Subdivision
Temporary Use Permit
UGB Amendment
Vacation
Variance/Adjustment
PC
Staff
Zone Ord/Map
Amendment
Other
FOR OFFICE USE ONLY
File No. Assigned:
Date Received: Fee Amount: Date Accepted as Complete:
Received By: Receipt No. Accepted By:
City Hall
169, SW Coast Hwy
Newport, OR 97365
541.574.0629
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City of Newport
Land Use Application
I undestand that I am responsible for addressing the legal criteria relevant to my application and
that the burden of proof justifying an approval of my application is with me. I aslo understand
that this responsibility is independent of any opinions expressed in the Community Development
and Planning Department Staff Report concerning the applicable criteria.
I certify that, to the best of my knowledge, all information provided in this application is accurate.
Applicant Signature(s) Date
Property Owner Signature(s) (if other than applicant) Date
Authorized representative Signature(s) (if other than
applicant)
Date
Please note application will not be accepted without all applicable signatures.
Please ask staff for a list of application submittal requirements for your specific type of request.