Planning Division General Application Form printable pdf download

This form, together with corresponding

application forms for specific permits,

GENERAL APPLICATION FORM

will become the permit document.

There is no fee for this form.

Type of Application

For City Use Only

 Conditional Use Permit: Minor / Major

Permit No: _______________________________

 Fence

___________________________

Project Name:

 Home Occupation Permit

 Preliminary Review by Staff

Date Permit filed: _________________________

 SPAR: Minor / Major

Date Permit issued: ________________________

 Tentative Map: ≤4 / ≥5 lots

 Zoning Amendment: Minor Revision _________

Received by: _____________________________

 Other:

Approved by (if applicable): _________________

Property Information

Land Use Information

(ask if unsure)

Address/Location:_____________________________

Existing Use of Property:______________________

Assessor’s Parcel No.:__________________________

General Plan Designation:_____________________

Property Size:_________________________________

Zoning Designation:_________________________

Historic Designation:_________________________

Contact Information

Owner:

________________________________

Agent:

_______________________________

Firm (opt.):

________________________________

Firm (opt.):

_______________________________

Phone:

________________________________

Phone:

_______________________________

Email:

________________________________

Email:

_______________________________

Address:

________________________________

Address:

_______________________________

________________________________

_______________________________

Authorization of Agent, Declaration of Accuracy, and Agreement for Inspection

(not required for Home Occupation Permit applications)

I, ________________________________, am the  owner /  agent of the property for which the

development or change is proposed. The above information and attached documents are true and accurate to

the best of my knowledge. I have read and agree with all of the above.

___________________________________

___________________________

Signature of Property Owner or Agent

Date

I, the owner, hereby  do /  do not authorize the agent to act on my behalf for this project, be notified of all

application proceedings, and agree to allow employees or authorized agents of the City of Petaluma to enter

upon the subject property, as necessary, to inspect the premises and process this application.

___________________________________

___________________________

Signature of Property Owner

Date

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General Application Form

Last updated: December 12, 2012

T: (707) 778-4470

City of Petaluma Planning Division

For faster responses, please e-mail us at:

11 English Street, Petaluma, CA 94952

Hours: 8 am – 12 pm and 1 pm – 5 pm,

petalumaplanning@ci.petaluma.ca.us

Mondays through Thursdays. Closed Fridays.

Planning Division General Application Form

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