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CLIFTON PLANNING COMMISSION
TOWN OF CLIFTON, VIRGINIA
APPLICATION FOR USE PERMIT
Revised by Planning Commission 08/06
The undersigned hereby applies for a Use Permit pursuant to Article 2, Section 9-10 of the Zoning Ordinance of the Code of Town of Clifton, Virginia. The undersigned has enclosed herewith a check made payable to the "Town of Clifton" for the required application review fee.
Date Submitted to Town Clerk: ____________________
Date Submitted to Chairman of Planning Commission: ____________________
1. Type: ~ Construction ~ Residential ~ Non-Residential ~ Home Business
2. Name of Applicant: ___________________________________________________________
3. Owner of Property: ___________________________________________________________
4. Name of Business/Organization: _________________________________________________
5. Owner of Business/Organization: ________________________________________________
6. Address of Premises: __________________________________________________________
7. Tax Map Number: ____________________________________________________________
8. Attach Copy of Plat for Property: ~ Plat Attached
9. Attach Floor Plan (All Non-Residential and Home Business): ~ Floor Plan Attached
10. Zoning District of Premises:
~ Residential ~ Commercial ~ Agricultural ~ Industrial
11. Describe Purpose of Application:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
12. If Commercial, Home Business, Agricultural or Industrial:
· Describe Operation: _______________________________________________________
· Number of Employees: ____________________________________________________
· Days and Hours of Operation: _______________________________________________
· Number of Client Visits per Day: ____________________________________________
· Square Footage of Premises: ________________________________________________
· Number of Off-Street Parking Spaces Available: ________________________________
· Number of Off-Street Parking Spaces Required: _________________________________
· For Home Business Only, Gross Square Footage of Dwelling: _____________________
13. Application Fee Enclosed: __________
($250 for new home or commercial construction; $150 for adding to existing buildings, or new residential construction other than new homes, where the addition or new construction costs over $25,000; $25 for all other construction, and any other use permit)
______________________________ ______________________________
Signature of Applicant/Agent Signature of Landlord/Lessor
______________________________ ______________________________
Date Date
______________________________ ______________________________
Mailing Address Mailing Address
______________________________ ______________________________
City/Town, State, Zip Code City/Town, State, Zip Code
_____________________________ ______________________________
Phone Number / Fax Number Phone Number / Fax Number
______________________________ ______________________________
E-Mail Address E-Mail Address
USE PERMIT APPLICATION
REQUIRED LEGAL NOTICE OF MEETING
PROCEDURES
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Once the Use Permit application is accepted by the Chairman of the Town Planning Commission for processing, the Applicant shall be furnished the Application Notice and the Statement of Compliance form prepared by the Planning Commission.
2. The Applicant is required to post the notice of the Use Permit application in the Clifton Post Office and on the Application property at least one week before the Planning Commission and Town Council meeting at which the application will be considered.
3. The Applicant must be present at all meetings on the application.
4. Prior to each meeting before the Planning Commission and Town Council, the Applicant shall submit the Statement of Compliance form to certify that the required notice has been posted in accordance with the provisions of the Zoning Ordinance.
STATEMENT OF COMPLIANCE FOR
NOTIFICATION PROCEDURES
FOR USE PERMIT APPLICATIONS
Name of Applicant: _________________________________________
Application Property Address: ________________________________
I certify, as the Applicant, that I have posted the required legal notice for the Planning Commission meeting on ___________ and the Town Council meeting on _____________, at the Clifton Post Office and on the application property in accordance with the provisions of the Zoning Ordinance.
Signed Date
STATEMENT OF COMPLIANCE FOR
NOTIFICATION PROCEDURES FOR
CERTIFICATE OF APPROPRIATENESS APPLICATIONS
Name of Applicant: ________________________________
Application Property Address: ________________________________
I certify, as the Applicant, that I have posted the required legal notice for the Architectural Review Board meeting on ________________________, at the Clifton Post Office and on the application property in accordance with the provisions of the Zoning Ordinance.
Signed Date
STATEMENT OF COMPLIANCE WITH USE PERMIT APPLICATION REQUIRED LEGAL NOTICE OF MEETING PROCEDURES
The applicant hereby states and certifies the following:
1. The applicant has filed an application for a use permit on ______________, 20____ with the Town Clerk and the Planning Commission.
2. The applicant has posted notice of the Use Permit application in the Clifton Post Office and on the applicant's property on ____________, 20___, which is at least one week before the Planning Commission and Town Council meetings at which the application will be considered, in accordance with the Use Permit Application Required Legal Notice of Meeting Procedures.
3. The applicant has paid all fees in connection with the application which are due at the time of the application.
Dated: _____________, 20___
Signature: ___________________
Name:_______________________
Property Address: _______________________
_______________________
STATEMENT OF COMPLIANCE FOR
NOTIFICATION PROCEDURES FOR
CERTIFICATE OF APPROPRIATENESS APPLICATIONS
Name of Applicant: ________________________________
Application Property Address: __________________________
I certify, as the Applicant, that I have posted the required legal notice for the Architectural Review Board meeting on ________________________, at the Clifton Post Office and on the application property in accordance with the provisions of the Zoning Ordinance.
Signed Date
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