Application for Zoning Certificate - Village of Carroll, Ohio

Application No:

Date Filed:

Void After:

To The Village of Carroll Planning and Zoning Board:

The undersigned hereby applies for a Zoning Certificate for the following use, to be issued on the basis of the representation contained herein, all of which applicant swears to be true.

1. The building, structure or premises for which a certificate is requested is as follows:

Address:

Lot No.

Addition:

Parcel No.

Current Zoning Classification:

2. Name(s) of Property Owner(s)

Address of Property Owner(s):

Telephone No:

3. Name(s) of Occupants(s) of Property:

4. Present Use of Property (Include All Uses on Site):

6. Site Plan to be attached and dimensions (a) trough (g) completed (see attached for Site Plan requirements):

(a) Main road frontagefeet

(b) Set back from center of road or streetfeet

side

feet

side

feet

(d) Set back from rear lot linefeet

(e) Depth of lot from center of road or streetfeet

(f) Dimensions of building:

Widthfeet

Depthfeet

(g) Highest point of building above established gradefeet

7. Building use

Number of stories

Basement

Usable floor space designed for use as living quarters, exclusive of utility area, basements, porches, garages, breezeways, terraces, attics, or habitable space over a first floor.

Living Space (first floor)square feet

Living space (second floor)square feet

Total Square Feet(including garage, porch, deck, patio, ect.)

68 Center St PO Box 367 Carroll, Ohio 43112-0367 740-756-4031 fax: 740-756-4611

8. Parking:

Number of Existing Spaces:

Number of Handicapped Spaces

Number of Loading Spaces (if applicable):

Number of Proposed Spaces

9. Names, address and telephone number of architects for project

10. Name, address and telephone number of contractor for project

11. Remarks and / or additional comments:

12. The Zoning Certificate does not relieve the applicant from the responsibility of obtaining all other required permits And approvals, including but not limited to access permits from the Village of Carroll, County of Fairfield and State of Ohio. Applicant(s) and owner(s) should also coordinate with utility companies for all required easements, right-of-ways and setbacks.

13. A fee for application processing, as determined by the Zoning Board: $

14. I hereby certify, to the best of my knowledge, that the forgoing statements and the information provided on the attached Site Plan are true and accurate. I understand that approval of this application does not relieve me of my obligation to obtain all other necessary permits.

Name Of Applicant(s) (Print)

Telephone Number of Applicant(s)

Applicant(s) is/are

Owner(s)

Occupant(s)

Owner’s Agent

Other

Witness:

Applicant(s)

TO BE COMPLETED BY ZONING INSPECTOR

Permit Approved

Permit Denied

I hereby approve/deny this Application for Zoning Certificate for the purposes as stated herein and as shown on Site Plan by applicant(s).

DATE:

Zoning Inspector

Reason(s) for Denial:

68 Center St PO Box 367 Carroll, Ohio 43112-0367 740-756-4031 fax: 740-756-4611