Please make an appointment with a planner to have this form completed, 321-633-2070.
Please be prepared to leave a copy of the plan and this form to retrieve at a later date.
Project Name ___________________________________________ Project # _____________
_________ _______ ________ _______ ______ ______________ ________________
Township Range Section SD# Block Lot(s) Parcel(s)
Site Address (if applicable) _______________________________________________________
Applicant’s Name _______________________________________________________________
Address __________________________________________ Phone______________________
__________________________________________ Fax _______________________
Owner’s Name __________________________________________________________________
Address ________________________________________________________________________
Proposed Use ___________________________________________________________________
Office Use Only
This form does not guarantee that a zoning action or variance will not be required for approval of your
project. This form does not represent a complete review of your plans, does not establish a right to develop
the property and does not constitute a waiver to any other applicable land development regulations. At the
time of development, this property will be subject to all such regulations.
_________________________ ______________________
(Zoning Staff Signature) (Date)
LDD 99 (revised 12/09/19)
Current Zoning: _______________________ Zoning Resolution #(s) ______________________
BDP: _______________________________
Surrounding Property Zoning Classifications:
Variance: ___________________________ N ________ S ________ E ________ W ________
CUP: _______________________________
Future Land Use: _____________________ Joint Planning Area:__________________________
Permitted in existing zoning classification. Subject to section: _____________________________
Permitted use in existing zoning classification with conditions found in section(s):
NOT PERMITTED WITHOUT A ZONING ACTION: ______________________________________