Fillable I. SITE INFORMATION Please refer to Zoning Office (Borough of Merchantville)

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I. SITE INFORMATION Please refer to Zoning Office (Borough of Merchantville)

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U.S.A. forms for Borough of Merchantville

BROWSE BOROUGH OF MERCHANTVILLE (NJ) FORMS

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F:\ S h a r e s \ C o m m u n i t y D e v e l o p m e n t \ F o r m s \ Z o n i n g P e r m i t f o r U s e s \ N e w \ Z P U s e s
9 . 1 2 . 1 9 . d o c x
DATE APPLICATION SUBMITTED: _________________
ZONING PERMIT FEE: Please take application to Finance Office to pay fee prior to submitting application.
Use Permitted by Zoning Ordinance, Variance, or Change of Tenancy $50
Certificate of Legal Non-Conforming Use (only within 1 yr of ordinance change) $25
I. SITE INFORMATION Please refer to Zoning Office webpage for the Tax map, Zoning map, parcel
zoning list on www.merchantvillenj.gov if you do not know this information.
SITE ADDRESS ________________________________ ZONING DISTRICT___________
TAX ASSESSOR’S BLOCK _______ LOT(S) _________
LOT SIZE ___________
II. APPLICANT INFORMATION
SAME AS OWNER POTENTIAL PURCHASER POTENTIAL TENANT
APPLICANT OWNER
CONTACT NAME: ___________________________ CONTACT NAME: ______________________________
BUSINESS NAME: ___________________________ BUSINESS NAME: ______________________________
ADDRESS: _________________________________ ADDRESS: ___________________________________
CITY, STATE, ZIP: ___________________________ CITY, STATE, ZIP: _____________________________
EMAIL: ____________________________________ EMAIL: ______________________________________
PHONE: ___________________________________ PHONE: _____________________________________
I have read this document in its entirety and consent to the making I have read this document in its entirety and consent to the making
of this application: of this application:
SIGNATURE: _____________________________ SIGNATURE: _________________________________
**BOTH SIGNATURES REQUIRED IF APPLICANT IS DIFFERENT THAN PROPERTY OWNER**
III. PROPERTY HISTORY
A. OCCUPANCY. IS THE PROPERTY CURRENTLY OCCUPIED? ________ IF VACANT, HOW LONG? __________
B. PROPERTY HISTORY. DESCRIBE IN DETAIL THE NATURE OF USES AND DATES.
Nature of Use: Date of Commencement:
__________________________________________________________________ _________________________
__________________________________________________________________ _________________________
C. PRIOR BOARD APPLICATIONS? HAS THE PROPERTY RECEIVED PRIOR ZONING OR PLANNING BOARD
APPROVAL? IF SO, PLEASE PROVIDE DETAILS (WHO, WHAT, WHEN). Attach copy of Board Resolution.
____________________________________________________________________________________
____________________________________________________________________________________
Merchantville Zoning Permit Application
Use Permit
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IV. PROPOSED USE
A. PROPOSED USE. DESCRIBE IN DETAIL THE PROPOSED USES AND ACTIVITIES TO BE CONDUCTED ON THE
PROPERTY. Be specific. (1) what type of goods or services, (2) days and hours of operation, (3) peak shift # of
employees/personnel on site, (4) # of seats/tables, (5) will there be outdoor activities, (6) when and how often will you
get deliveries, (7) how will trash be disposed, (8) any exterior changes.
Attach additional sheets if necessary.
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
B. ADDITIONAL DETAILS. PLEASE WRITE “N/A” IF NOT APPLICABLE.
EXISTING PROPOSED
RESIDENTIAL: HOW MANY DWELLING UNITS? __________ __________
HOW MANY BEDROOMS IN EACH DWELLING UNIT? __________ __________
HOW MANY ON-SITE PARKING SPACES? __________ __________
COMMERCIAL: HOW MANY COMMERCIAL USES ON SITE? __________ __________
HOW MANY ON-SITE PARKING SPACES? __________ __________
C. ARE THERE OTHER APPROVALS REQUIRED FOR PROPOSED USE? Business Registration, Fire Inspection,
County Health Department, County Planning Board, NJDEP, etc.? Please describe type, and provide status.
__________________________________________________________________________________________________
__________________________________________________________________________________________________
V. ZONING OFFICER USE ONLY (DO NOT WRITE BELOW)
A. PROOF OF PAYMENT RECEIVED BY FINANCE OFFICE?
YES NO AMOUNT PAID: ________ DATE FEE PAID: ________
B. ZONING PERMIT DISPOSITION:
APPROVED: ______ DENIED: ______ IF APPROVED, ZONING PERMIT NO.: ____________
Change of Tenancy Use Permitted by Ordinance
Use Permitted by Variance, subject to any conditions attached thereto. Dated: ______ File No. ____________
Valid nonconforming use as established by ( ) finding of the Joint Land Use Board or ( ) by the undersigned
Zoning Officer on the basis of evidence supplied by applicant within 1 year of ordinance change.
DATE: _________________________
ZONING OFFICER’S NAME: ___________________________SIGNATURE: ______________________________________
COMMENTS: _______________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
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SWORN & SUBSCRIBED to before me this
________Day of _____________, 20_____ (year)
__________________________________ (Notary)
BUSINESS ORGANIZATION
OWNERSHIP DISCLOSURE STATEMENT
You must complete this form for each applicant and/or property owner that is not a sole proprietor.
NAME OF CORPORATION, PARTNERSHIP, LIMITED LIABILITY COMPANY, LIMITED LIABILITY
PARTERSHIP, OR S-CORPORATION:
_____________________________________________________________________
_____________________________________________________________________
Listed below are the names and addresses of all owners of 10% or more of the interest/stock in the above
referenced business organization:*
*If a corporation or a partnership owns 10% or more of the stock of a corporation, or 10% or greater interest in
a partnership, that corporation or partnership shall list the names and addresses of its stockholders holding 10%
or more of its stock or of 10% or greater interest in the partnership, and this requirement shall be followed until
the names and addresses of the non-corporate stockholders and individual partners, exceeding the 10%
ownership criterion established have been listed.
SIGNATURE DATE
NAME OF AUTHORIZED OFFICIAL
________________________________________
TITLE
11111
11213321133
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I. SITE INFORMATION Please refer to Zoning Office (Borough of Merchantville)

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Completed 20 February 2021

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