Fillable Universal Development Application (City of Lake Worth Beach)

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Universal Development Application (City of Lake Worth Beach)

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The Universal Development Application (City of Lake Worth Beach) form is 2 pages long and contains:

  • 4 signatures
  • 24 check-boxes
  • 63 other fields

Country of origin: US
File type: PDF

U.S.A. forms for City of Lake Worth Beach

BROWSE CITY OF LAKE WORTH BEACH (FL) FORMS

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Universal Development Application
6-19 City of Lake Worth Beach / Department for Community Sustainability / Planning, Zoning, & Historic Preservation Division
Page 1 of 2 1900 2nd Ave N, Lake Worth Beach, FL 33463 / 561-586-1687 / pzoning@lakeworth.org
This application is required for ALL applications submitted to the Planning, Zoning and Historic Preservation
Division. If you have questions regarding this application, please make an appointment with planning staff.
1. Application Type (select all that apply)
a. Site Plan: □ Minor □ Major □ Planned Development □ Sustainable Bonus
b. Use: □ Administrative □ Conditional
c. Proximity Waiver: □ Alcoholic Beverage □ Community Residence □ Gaming Establishment
□ Adult Use
d. Approvals: □ Variance □ Mural □ Cert. of Appropriateness □ Adjustment
e. Amendments: □ Rezoning / Map □ Text
f. Other: □ Subdivsion/Plat □ Annexation □ Zoning Letter
□ ABT Signoff □
2. Project Information
a. Project Name:
b. Project Location / Address:
c. Legal Description:
d. Property Control Number (PCN): 38-43-44-
e. Zoning: Existing: Proposed:
f. Future Land Use: Existing: Proposed:
g. Proposed Use: □ Residential; Units □ Commercial; S.F. □ Industrial; S.F.
h. Total Estimated Project Cost:
i. Description of Work:
3. Contact Information
a. Project Manager / Contact Person:
Company:
Address: City: St: Zip:
Phone Number: E-Mail Address:
b. Applicant Name (if different from Project Manager):
Company:
Address: City: St: Zip:
Phone Number: E-Mail Address:
c. Owner Name:
Company:
Address: City: St: Zip:
Phone Number: E-Mail Address:
6-19 City of Lake Worth Beach / Department for Community Sustainability / Planning, Zoning, & Historic Preservation Division
Page 2 of 2 1900 2nd Ave N, Lake Worth Beach, FL 33463 / 561-586-1687 / pzoning@lakeworth.org
4. Owner’s Consent
(“Owner”) certifies that it is the owner of the property located at
(“Subject Property”) and expressly consents to the use of the Subject
Property as described in this application and to all conditions that may be agreed to as a part of the approval of this application,
which may be imposed by the decision making board. Owner hereby authorizes, as
agent, to file this application and represent Owner at any and all meetings and hearings required for the approval of this application.
Owner’s Signature: ˟ Date:
Name/Title of Signatory:
STATE OF
COUNTY OF
The foregoing instrument was acknowledged before me this day of , 20 , by
who is personally known to me or who produced a as identification. He/she did not take an oath.
(NOTARY SEAL) ˟
(Signature of Notary Public)
(Name of Notary)
5. Affidavit of Completeness and Accuracy
Instructions: To be completed by the individual submitting the application (owner or authorized agent)
Project Name: Submittal Date:
STATEMENT OF COMPLETENESS AND ACCURACY:
I hereby certify all property owners have full knowledge the property they own is the subject of this application. I hereby certify that
all owners and petitioners have been provided a complete copy of all material, attachments and documents submitted to the City of
Lake Worth relating to this application. I further certify the statements or information made in any paper or plans submitted herewith
are true and correct to the best of my knowledge. I understand this application, related application material and all attachments
become official records of the Planning, Zoning and Historic Preservation Division of Lake Worth, Florida, and will not be returned. I
understand that any knowingly false, inaccurate or incomplete information provided by me will result in the denial, revocation or
administrative withdrawal of this application, request, approval or permit. I further acknowledge that additional information may be
required by Palm Beach County to process this application. I further acknowledge that any plans that I have prepared or had prepared
comply with the Fair Housing Standards. I further consent to the City of Lake Worth to publish, copy or reproduce any copyrighted
documents submitted as a part of this application for any third party. I further agree to all terms and conditions, which may be imposed
as part of the approval of this application.
˟
(Name – type, stamp, or print clearly) (Signature)
(Name of Firm) (Address, City, State, Zip)
STATE OF
COUNTY OF
The foregoing instrument was acknowledged before me this day of , 20 , by
who is personally known to me or who produced a as identification. He/she did not take an oath.
(NOTARY SEAL) ˟
(Signature of Notary Public)
(Name of Notary)
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Universal Development Application (City of Lake Worth Beach)

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Completed 18 January 2021

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