_____ Applicant’s Initials P a g e | 1 October 2019
Manufactured Home Park
City of Baton Rouge / Parish of East Baton Rouge
Office of the Planning Commission, 1100 Laurel Street, Suite 104
Baton Rouge, Louisiana 70802
Staff Use Only
Fee(s): ___________________ Application Taken by: _______________
Case Number: _________________ Meeting Date: _____________________
MPN Project Number: _______________
Please Print or Type (all entities listed below will be copied on all comments)
1. Applicant Name: __________________________________________________________________
Email Address: __________________________ Daytime Phone Number: ____________________
Business (if applicable): ____________________________________________________________
Address: ____________________________ City: ____________ State: _________ ZIP: _________
2. Developer (if applicable): ___________________________________________________________
Email Address: ___________________________________________________________________
3. Name of Property Owner: __________________________________________________________
Email Address: __________________________ Daytime Phone Number: ____________________
Address: _________________________ City: _______________ State: _________ ZIP: _________
4. Subject Property Information:
CPPC Lot ID#(s): __________________________________________________________________
Lot #(s): _____________________________ Block/Square: _______________________________
Subdivision or Tract Name: _________________________________________________________
(If property is not subdivided, attach a complete legal description and a survey map indicating
bearings and dimensions.)
Nearest Intersection: ______________________________________________________________
5. Specific proposed use (Type of development and general background):
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
6. Waiver(s) requested:
Yes No
If “Yes” specify the ordinance section and paragraph and give justification for the requested
waiver(s):
________________________________________________________________________________
________________________________________________________________________________
Date Received: ______________
_____ Applicant’s Initials P a g e | 2 October 2019
7. Access:
Private Street Public Street (City-Parish) Public Street (State)
If street is a State Road/Highway, approval is contingent upon LADOTD approval of access.
8. Parking:
(Specify the number of parking spaces that will be proposed in addition to the required amount.)
________________________________________________________________________________
________________________________________________________________________________
9. Stormwater Management Plan (SMP):
Submitted Not Submitted If not submitted please explain:
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
10. Drainage Impact Study:
Submitted Not Submitted If not submitted please explain:
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
11. Water Quality Impact Study:
Submitted Not Submitted If not submitted please explain:
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
12. Acknowledgement:
I acknowledge that private deed restrictions or covenants may exist on the subject property. I
recognize that neither the Planning Commission nor its staff may consider such deed restrictions
or covenants, if any, when determining approval or denial of an application, nor can the City or
Parish enforce private deed restrictions or covenants. It is my responsibility as an Applicant to
determine if any such deed restrictions and covenants exist on the subject property, and to be
aware that violations of the same subject me and/or Property Owner to litigation from others.
I acknowledge that the Planning Commission makes the final decision on the approval or denial of
this application. I also recognize I do not have a right to an approval, regardless of staff
certification that the application meets ordinance requirements. A Public Hearing is required to
be held and the Planning Commission will make the decision based upon all evidence presented
at the meeting.
I understand that the application fee is nonrefundable. (Applications must be received by
10:00a.m. on the scheduled Application Deadline.)
P a g e | 3 October 2019
Application must be signed by both applicant and property owner if different. Letter of
authorization must be submitted in absence of the property owner’s signature or where an
authorized agent signs in lieu of either property owner or applicant.
Signature of Applicant Type or Print Name of Applicant Date
Signature of Property Owner Type or Print Name of Property Owner Date
click to sign
signature
click to edit
click to sign
signature
click to edit
P a g e | 4 October 2019
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. Parcel ID #(s): ____________________________________________________________________
K. Council District: 1 2 3 4 5 6 7 8 9 10 11 12
L. Waiver(s) requested: No Yes
M. Complete Check List: No Yes
N. Comments: ______________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
O. Is subject property within Zone of Influence (Zachary, Central, BREC, or Health District)? If so,
contact as needed.
No Yes date correspondence sent: _________________
P. Is subject property located on MoveBR? If so, contact as needed.
No Yes date correspondence sent: _________________
Q.
Planning Director or Authorized Signature Date