Zoning Certificate Application Form printable pdf download

ZONING CERTIFICATE APPLICATION FORM

APPLICATION

NO.

CITY OF PICKERINGTON

App # _______________________

PLANNING & ZONING DEPARTMENT

Permit # _____________________

51 EAST COLUMBUS STREET

office use

PICKERINGTON, OH 43147 (614) 833-2204, FAX (614) 833-2273

website address:

ZONE DISTRICT

AUDITOR’S PARCEL NO.

LOT NO.

CASH

CHECK #

RECEIPT #

PROJECT

“

INFORMATION

zip code:

PROJECT ADDRESS

street #:

SUBDIVISION / PROJECT DEVELOPMENT NAME

NAME ↓

STREET ADDRESS ↓

CITY, ST. ZIP ↓

PHONE # ↓

PROPERTY OWNER - Who owns the land

ARCH / ENG / SURVEYOR / CONTRACTOR -

Plans by

APPLICANT - Who is handling the permits

DESCRIBE PROPOSED WORK:

RESIDENTIAL:

NON-RESIDENTIAL:

NEW SINGLE FAMILY RESIDENCE

SITE PLAN

NEW SIGNS

SQ, FT,- Living space ____________,

BUILDING __________________________________

Garage ___________ , basement___________

GROUND _________________________________

ARCHITECTURE (NEW/ADDITION) GROSS SQ.

Meets the Residential Building Design

FT.(calc. per structure)_________________________

Standards (Chapter 1276.23)

ADDITION

NEW MULTIPLE FAMILY RESIDENCE

LANDSCAPING

SIGNS - FACE CHANGE

NO. OF UNITS ___________________________

(as of Right)

LIGHTING

SQ, FT, __________________________________

ACCESSORY GARAGE or SHED

CHANGE OF USE / NEW TENANT

SIGNS – TEMPORARY

SQ. FT. __________________________________

NEW JOBS: FULL- TIME_______ PART-TIME _______

START DATE ______________________

SWIMMING POOLS (in ground or above ground)

COMMERCIAL ALTERATIONS

POOLS or TANKS (in ground or above ground)

pool size SQ. FT. __________________________

PARKING ANALYSIS

SQ. FT. _________________________________

FENCES or WALLS (Includes Retaining Walls)

EXISTING USE / INTERIOR ALTERATIONS,

FENCES or WALLS (Includes Retaining Walls)

NO PARKING ANALYSIS = NO APPLICATION

PATIO / DECKS (attached or detached)

IN HOME OCCUPATION CERTIFICATE

PARKING LOT, NEW PAVEMENT or RESTRIPING

TENTS; TEMPORARY SALES;

YARD SALE

OTHER STRUCTURAL ADDITIONS

OTHER: ______________________________

OTHER: NONCONFORMING USE CERT; ETC.

Impact Fee

Yes $______________ (see attached Impact Fee Estimate Form)

The applicant does hereby covenant and agree to comply with all the laws of the State of Ohio and the Zoning Code of Pickerington, Ohio, pertaining to building and buildings,

and to construct the proposed building or structure or make the proposed change or alteration in accordance with the plans and specifications submitted herewith, and certify

that the information and statements given on this application, drawings and specifications are to the best of their knowledge, true and correct. The applicant by signing this

form acknowledges that the owner of the building/property is aware and in agreement with this application.

APPLICANT SIGNATURE

DATE

DO NOT WRITE BELOW THIS LINE (office use)

Case No.

Date:

Case No.:

Date:

BZA RES. NO.

Certificate of Appropriate:

AMENDMENT:

Case No.

Date:

As-of-Right Development

Date:

APPROVED BY

Date

CERTIFICATE FEE TYPE

FEE $

APPROVAL CONDITIONS (If any):

Submittal Date

Approval Date

Building Materials:

Site Plan:

Landscaping Plan:

Lighting Plan:

Signage:

FEE SCHEDULE – (per Ordinance 2007-3)

Residential – New and Multi-Family Use per dwelling $125.00 ($50.00 re-application fee); Existing Residential Additions $25.00

Sign Certificates - Permanent - $50.00

Non residential uses - $125.00 for each use (change of use/new tenant, commercial alteration, parking lot, other structural or site plan additions, etc.)

Lot Split - $ 100.00 per Split

SUBMISSION REQUIREMENTS – 2 COPIES OF SITE PLAN, ELEVATION, ETC.

A Certificate of Zoning Compliance should include some or all of the following information:

• PROJECT INFORMATION: Project Name; Owner Name; Builder Name; Plans Prepared by;

• IDENTIFY: Property Lines; Street Name(s); Existing & Proposed Structures including attached decks, cantilevers, accessory structures, fences, pavement, driveways,

walks, easements, grades, etc.

• DIMENSIONS: of property lines; site size; setbacks from structure to all property lines; parking layout dimension details; other. Legibly drawn to scale is preferred.

• PARKING: analysis/calculations, impervious surface ratio calculations.

• NORTH ARROW: (typically with North to top or right of plan)

• Meets the Residential Building Design Standards (Chapter 1276.23)

DO NOT WRITE BELOW THIS LINE (office use)

Revised 12/7/15