Zoning CertificateLAND USE AND ZONING CERTIFICATE: NON-REStDENTIAL
LOC subsection 10.02.05 8.1.f
Chapter 4 K. of th€ Administrative Code
Please fill out this form as completely as possible, if you don't know the answer, indicate "unknown", if the item doesn't
apply, indicate "not applicable" or "N/A". Your application can not be processed without all of the necessary information.
Zoning approval of this application can be expedited if a site plan of the property to be occupied showing parking and
surrounding uses is submitted with the application.
Zoning Certificate r:fl Relocating Existing Business ffi New Business
Additional development orders may be required by the County for any chantes in use and/or interior and exterior
remodelinS. Please be advised that lmpact Fees may be due at time of Eullding Permit. Please contact lmpact Fee
Administration at (239) 252-2991 and Public Utilitles at 12391 252-6237 to verfi if any impact fee will be assessed.
(Applicant's initials):
APPLICANT CONTACT I NFORMATION
o^ l-[oName of Applicant(s)
Address:
Telephone:\o o Cell
E-MailAddress:
Business Owner or Qualifie/s Name It
Eusiness Name:
Business Address:
Property Owner or l-easing Agent Name:
fla0l,,State
Fax:
?L a* AuCity:t4
City:0.eL,
Eusiness Phone:
State:t* aqtyL
Complex Name (lf any):_
Type of Eusiness nb.. V\ou4e,
Type and Name o, Susiness Prevlously or Presently Occupying Lo6tion:
lf Vacant, P,ovide Len8th of Vacancy:
Check below if the buslness is any of the followint buslness typest:
E Restaurant/Eating Places (SlC 5612)
E Ba r/N ig ht Club/Drin king Pla.es (SlC 5813) - will requirea distance waiver.
f] Restaurant/Bar with 150 seats or more
!Alcohol Licenses will not be signed off by the Planning and Zoning Department until the Business Tax Receipt has been
issued lf the license is for consumption on premises, a floor plan will be required showing the location of all serving areas
and seatinB.
BUSINESS & USE INFORMATION
r/1412074 PaBe 1 of 2
C-a et C-ouuty
BUILDING INFORMATION
Bullding Type: fr Single-Occupancy Building I Retail ShoppinS Center E Office/Professional/Business Center
Bullding Use, indicate the approximate square footage the unit or building is used for:
Reta il Storage Office:
Manufacturing / Repair:
Total BuildinS Floor Area
Other, describe:
1
Auto Repair/Service Station:# of Bays
Restaurant/church/Beauty salon:# of Seats
lot (if over 100 spaces state "common")
ecified: lo l
Number of Parking space for Building / complex:
Number of parking spaces available for unit, if sp
I declare under penalty of perjury the foregoing facts are true and correct to the best of my knowledge
Applicant Signature Date
6
il1
.r \t
stc s:
Building Permit 8:
site Visit Required: n Yes E tto
ments/R ons:
E Hotd E Denied
Planner
.The followint to be completed by County Staff;
tng:Property lD n
(if available) SDP f:
6
(if available)
\erD rr./\
VI s\.g.07 )a.r est- to 5'w
\
1,/14/2074
Date
Page 2 of 2
Zoning Certificate Review Fee: S125.00 (checks payable to: "Board of County Commissioners")
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