Fillable VARIANCE PERMIT APPLICATION CITY OF LACEY Community & (City of Lacey)

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VARIANCE PERMIT APPLICATION CITY OF LACEY Community & (City of Lacey)

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FORM: VAR-1
PAGE 1
CITY OF LACEY
Community & Economic Development Department
420 College Street SE
Lacey, WA 98503
(360) 491-5642
VARIANCE PERMIT
APPLICATION
DATE:
DATE:
DATE:
DATE:
SIGNATURE(S)
I (We), the above-signed, do hereby affirm and certify, under penalty of perjury, that I/we am/are one (or more) of
the owner(s) under contract of the below described property and that the following statements and answers are in all
respects, true and correct on my information and belief as to those matters.
OWNER NAME:
MAILING ADDRESS:
CITY, STATE, ZIP:
TELEPHONE:
APPLICANT NAME:
MAILING ADDRESS:
CITY, STATE, ZIP:
TELEPHONE:
SIGNATURE: DATE:
ENGINEER/ARCHITECT NAME:
MAILING ADDRESS:
CITY, STATE, ZIP:
TELEPHONE:
SIGNATURE: DATE:
OFFICIAL USE ONLY
Case Number: ___________
Date Received: __________
By: ___________________
Related Case Numbers:
_______________________
_______________________
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FORM: VAR-1
PAGE 2
PROPERTY LOCATION
[ ]North [ ]South [ ]East [ ]Wes
t Side of between
(ROAD NAME)
and
(ROAD NAME)
Property Address:
Section: Township: Range: Assessor’s Parcel Number:
Full legal description of subject property:
(ATTACH SEPARATE SHEET IF NECESSARY)
AUTHORIZED REPRESENTATIVE:
MAILING ADDRESS:
CITY, STATE, ZIP:
TELEPHONE:
SIGNATURE: DATE:
NAME OF PROJECT:
SUMMARY OF REQUEST (List Type of Uses):
THE FOLLOWING QUESTIONS MUST BE ANSWERED COMPLETELY.
IF ADDITIONAL SPACE IS NEEDED, ATTACH EXTRA PAGES TO THE APPLICATION
1. List the provision(s) of the Zoning Ordinance from which you are seeking a variance:
2. Floor space of buildings
Existing:
Addition:
Entire:
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FORM: VAR-1
PAGE 3
3. How many cars may be parked off the street on the site:
Describe other parking provisions:
4. What are the exceptions or extraordinary circumstances which lead the applicant to believe he is
entitled to a variance:
5. What characteristics of your property prevent it from being used for any of the uses permitted in
your zone (also illustrate on the site plan)?
Too Narrow Elevation Soil
Too Small Slope Subsurface
Too Shallow Shape Other
6. Is the change you are requesting for a use not permitted in the zoning district? [ ] Yes [ ] No
Explain:
7. What are the special conditions of your land which lead you to believe you are entitled to a
variance?
8. To the best of your knowledge, can you affirm that the hardship described above was not caused
by an action of anyone having property interests in the land after the Zoning Ordinance or
applicable part thereof became law? [ ] Yes [ ] No If no, explain why the hardship should
not be regarded as self-imposed (self-imposed hardships are not entitled to Variance):
9. If your variance request is granted, would it confer upon you a special privilege that is denied
other lands in the same district? [ ] Yes [ ] No Explain:
10. How will the granting of the variance be in harmony with the neighborhood and not be
detrimental to the public welfare or to properties in the vicinity?
11. Is this the minimum variance that will make possible the reasonable use of the land? [ ]Y [ ]No
Explain:
FORM: VAR-1
PAGE 4
12. How will the granting of the variance be in harmony with the purpose and intent of the zoning
ordinance?
TWELVE (12) COPIES OF THE SITE PLAN DRAWING AND APPLICATION SHALL BE
SUBMITTED, WHICH MUST INCLUDE ALL OF THE FOLLOWING:
NOTE: The site plan must be at a scale of not less than 20 feet to an inch and not more than
100 feet to an inch.
1. The location of all existing and proposed structures, including, but not limited to, buildings,
fences, culverts, bridges, roads and streets. Include setbacks from property lines.
2. The boundaries of the property proposed to be developed.
3. All means of vehicular and pedestrian ingress and egress to and from the site, and size and
location of driveways.
4. The location and design of off-street parking areas showing their size and locations for internal
circulation and parking spaces.
Variances are for the modification of size, dimension or design requirements of a zoning district in
situations where unusual physical conditions of the property, such as shape or topography, make it
impossible or unduly difficult to meet requirements of the zoning district. The power to vary is
limited to the minimum change necessary to overcome the inequality inherent in the property.
Variances are not for the purpose of permitting a use prohibited or not permitted in the district.
Variances are granted only when the following specific circumstances exist:
1. The change must not constitute a rezone; that is, it must not be for a use not permitted in the
district.
2. Special physical conditions must exist on the property, which makes literal application of zoning
requirements impossible to meet, or which cause undue hardship.
3. The special conditions peculiar to the property must not result from actions of the applicant.
4. The variance must not confer a special privilege that is denied to other properties in the same
district.
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VARIANCE PERMIT APPLICATION CITY OF LACEY Community & (City of Lacey)

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Completed 4 August 2020

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