Staff Use Only
A.
Land Use Classification(s):
B.
Zoning Classification(s):
C.
Existing Land Use(s):
D.
Surrounding Land Use(s):
E.
Surrounding Land Use Classification(s):
F.
Surrounding Zoning Classification(s):
G.
Proposed Land Use:
H.
Comprehensive Plan: ☐ Consistent ☐ Not Consistent
I.
Planning District/Sub Area:
J.
Census Tract:
K.
Lot and Block:
L. Council District: ☐1 ☐2 ☐3 ☐4 ☐5 ☐6 ☐7 ☐8 ☐9 ☐10 ☐11 ☐12
M.
DRC and/or Departments of Development and Transportation and Drainage Compliance:
□ No ☐ Yes If “No” explain:
N.
Stormwater Management Plan (SMP):
□ No ☐ Yes If “No” explain:
O.
Drainage Impact Study (DIS):
□ No ☐ Yes If “No” explain:
P.
Water Quality Impact Study (WQIS):
□ No ☐ Yes If “No” explain:
Q.
Waiver(s) Requested: ☐ No ☐ Yes
R.
Complete Check List: ☐ No ☐ Yes
S.
Comments:
T.
Is subject property within Zone of Influence (Zachary, Central, BREC, or Health District)? If so,
contact as needed.
□ No ☐ Yes – date correspondence sent:
U.
Is subject property located on MoveBR? If so, contact as needed.
□ No ☐ Yes – date correspondence sent:
V.
Planning Director or Authorized Signature Date