City of Pompano Beach
Department of Development Services
Planning & Zoning Division
100 W. Atlantic Blvd Pompano Beach, FL 33060 Text Amendment Application
Phone: 954.786.4634 Fax: 954.786.4666
G:\Zoning 2009\Forms and documents\Website Documents\Planning & Zoning\Forms
Modified: 4.28.2020 Page 4 of 4
OWNER’S CERTIFICATE
This is to certify that I am the owner of the subject lands described in this application and that I have authorized
the filing of the aforesaid application.
By signing below, I acknowledge that development applications must have a determination by the governing
municipality of approved, approved with conditions, or denied within 120 days from a complete submittal for
projects that do not require final action through a quasi-judicial hearing or a public meeting and within 180 days
from a complete submittal for projects that do require final action through a quasi-judicial hearing or a public
meeting per FL Stat § 166.033 and the Pompano Beach Code Section 155.2303.F.3. It is the responsibility of
the applicant to receive all final Development Orders and receive this determination within the allotted
timeframe. If the applicant fails to resubmit an application within 30 calendar days after being first notified of
deficiencies of the submittal, the application shall be considered withdrawn and a $100 non-refundable
administrative fee will apply (155.2303.F.2.b). Additionally, if all required approvals are not received within the
allotted timeframe the application will automatically be denied unless both the City and the applicant agree to
an extension of time (155.2303.I).
Owner’s Name: ________________________________________________________________
(Print or Type)
Address: ________________________________________________________________
________________________________________________________________
(Zip Code)
Phone: ______________________________________
Email address: ________________________________________________________________
________________________________________________________________
(Signature of Owner or Authorized Official)
SWORN AND SUBSCRIBED before me this _____ day of _______________ , ______ by means of
[ ] physical presence or [ ] online notarization.
______________________________________________________________________________
NOTARY PUBLIC, STATE OF FLORIDA
______________________________________________________________________________
(Name of Notary Public: Print, stamp, or Type as Commissioned.)
[ ] Personally know to me, or
[ ] Produced identification: ___________________________________________________
(Type of Identification Produced)