Form Zrd1 - Zoning Resolution Determination Form Page 2
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3ZRD1: Zoning Resolution Determination Form
PAGE 2
5 Description of Request
(additional space is available on page 3)
NOTE: Buildings Department officials will only interpret or clarify the Zoning Resolution. Any request for variations of the Zoning Resolution must
be filed with the Board of Standards and Appeals (BSA) or the Department of City Planning (DCP).
Please itemize all attachments, including plans/sketches, submitted with this form. (attachment may not be larger than 11” x 17”)
If request is based on a plan examiner objection, type in the applicable objection text exactly as it appears on the Objection sheet and include a
copy of the Objection sheet in the submitted Pdf.
NOTE: Department of Buildings Determination will be issued on the ZRD1 Response Form
6 Statements and Signature
Required for all requests
(If Attorney, include ‘Esquire’ or ‘Esq.’ in signature)
Name (please print)
I hereby state that all of the above information is correct and complete to the best of
my knowledge. Falsification of any statement is a misdemeanor and is punishable
by a fine or imprisonment, or both. It is unlawful to give to a City employee, or for a
Signature
Date
City employee to accept, any benefit, monetary or otherwise, either as a gratuity for
properly performing the job or in exchange for special consideration. Violation is
punishable by imprisonment or fine, or both.
P.E./R.A. Seal (apply seal, then sign and date over seal –
not required for Attorneys on unfiled applications)
ADMINISTRATIVE USE ONLY
Control #:
Reviewed By:
Date:
01/18
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Parent category: Legal