CONDITIONAL USE PERMIT APPLICATION

SECTION 1: APPLICANT INFORMATION

Applicant Name: _______________________________________________

Company/Business Name (if applicable): _______________________________________________

Mailing Address: _______________________________________________

City/State/ZIP: _______________________________________________

Phone Number: _______________________________________________

Email Address: _______________________________________________

Applicant Capacity:
☐ Property Owner
☐ Lessee/Tenant
☐ Contract Purchaser
☐ Authorized Representative
☐ Developer
☐ Other: _______________________________________________

SECTION 2: PROPERTY OWNER INFORMATION

Property Owner Name: _______________________________________________

Entity Type (if not individual): _______________________________________________

Mailing Address: _______________________________________________

City/State/ZIP: _______________________________________________

Phone Number: _______________________________________________

Email Address: _______________________________________________

Owner Consent:
☐ Owner consent letter attached
☐ Applicant is the property owner

SECTION 3: PROFESSIONAL REPRESENTATIVES

Attorney (if applicable)

Name: _______________________________________________

Firm: _______________________________________________

Address: _______________________________________________

Phone/Email: _______________________________________________

Bar Number: _______________________________________________

Engineer/Surveyor (if applicable)

Name: _______________________________________________

Firm: _______________________________________________

License Number: _______________________________________________

Phone/Email: _______________________________________________

Architect (if applicable)

Name: _______________________________________________

Firm: _______________________________________________

License Number: _______________________________________________

Phone/Email: _______________________________________________

SECTION 4: PROPERTY INFORMATION

Street Address: _______________________________________________

City/Town: _______________________________________________

County: _______________________________________________

Tax Parcel/Assessor Number(s): _______________________________________________

Legal Description:
_______________________________________________
_______________________________________________
☐ Full legal description attached

Property Dimensions:
- Total Lot Area: _______________ ☐ acres ☐ square feet
- Lot Width: _______________ feet
- Lot Depth: _______________ feet

Current Zoning Classification: _______________________________________________

Overlay/Special Districts: _______________________________________________

General Plan/Future Land Use Designation: _______________________________________________

Existing Use(s) of Property: _______________________________________________

SECTION 5: CONDITIONAL USE REQUESTED

Use Description

Specific Conditional Use Requested:
_______________________________________________

Zoning Code Section Allowing Conditional Use:
_______________________________________________

Detailed Description of Proposed Use:
_______________________________________________
_______________________________________________
_______________________________________________
_______________________________________________
_______________________________________________

Use Category (check all that apply)

Residential:
☐ Accessory Dwelling Unit
☐ Multi-Family Housing
☐ Group Home/Residential Care
☐ Manufactured Home Park
☐ Senior Housing
☐ Other Residential: _______________________________________________

Commercial:
☐ Restaurant/Food Service
☐ Retail Sales
☐ Office/Professional Services
☐ Hotel/Motel
☐ Entertainment Venue
☐ Vehicle Sales/Service
☐ Fuel Station
☐ Drive-Through Facility
☐ Other Commercial: _______________________________________________

Institutional:
☐ Religious Institution
☐ School/Educational Facility
☐ Hospital/Medical Facility
☐ Government Facility
☐ Cemetery/Mausoleum
☐ Other Institutional: _______________________________________________

Industrial/Other:
☐ Light Industrial
☐ Warehousing/Distribution
☐ Recycling Facility
☐ Utility Facility
☐ Wireless Communication Facility
☐ Solar/Wind Energy
☐ Agricultural Use
☐ Mining/Extraction
☐ Other: _______________________________________________

SECTION 6: PROJECT SPECIFICATIONS

Building/Structure Information

New Construction:
☐ Yes ☐ No

If Yes:
- Proposed Building Footprint: _______________ sq. ft.
- Proposed Gross Floor Area: _______________ sq. ft.
- Number of Stories: _______________
- Maximum Building Height: _______________ feet
- Number of Buildings: _______________

If Existing Structure:
- Current Building Size: _______________ sq. ft.
- Proposed Modifications: _______________________________________________
- Year Built: _______________

Setbacks

Lot Coverage

• Maximum Allowed: ___________%
• Proposed Building Coverage: ___________%
• Proposed Impervious Coverage: ___________%

SECTION 7: OPERATIONAL INFORMATION

Hours of Operation

Days and Hours Open to Public/Customers:

Operational Hours (if different from public hours):
_______________________________________________

Staffing

• Total Number of Employees: _______________
• Maximum Employees per Shift: _______________
• Shift Schedule: _______________________________________________

Patrons/Customers/Clients

• Average Daily Number: _______________
• Maximum at Any One Time: _______________
• Peak Activity Periods: _______________________________________________

Special Events

• Frequency: _______________________________________________
• Maximum Attendance: _______________________________________________
• Description: _______________________________________________

SECTION 8: PARKING AND CIRCULATION

Parking Requirements

Parking Details

• Standard Spaces: _______________
• ADA Accessible Spaces: _______________
• Compact Spaces: _______________
• Loading Spaces: _______________
• Motorcycle/Bicycle Spaces: _______________

Access

• Number of Driveways: _______________
• Width of Driveways: _______________
• Access Street(s): _______________________________________________
• Traffic Signal/Control Required: ☐ Yes ☐ No

Circulation

Describe internal circulation and traffic flow:
_______________________________________________
_______________________________________________

SECTION 9: UTILITIES AND SERVICES

Water Supply

☐ Municipal Water System
☐ Private Water System
☐ Well

• Water Provider: _______________________________________________
• Estimated Daily Demand: _______________ gallons
• Fire Flow Requirements Met: ☐ Yes ☐ No ☐ TBD

Wastewater

☐ Municipal Sewer System
☐ Private Sewer System
☐ Septic System

• Sewer Provider: _______________________________________________
• Estimated Daily Flow: _______________ gallons

Stormwater

• Drainage Method: _______________________________________________
• Detention/Retention Required: ☐ Yes ☐ No
• BMP Measures Proposed: _______________________________________________

Other Utilities

• Electric Provider: _______________________________________________
• Gas Provider: _______________________________________________
• Solid Waste Provider: _______________________________________________
• Special Utility Needs: _______________________________________________

SECTION 10: ENVIRONMENTAL CONSIDERATIONS

Site Characteristics

☐ Wetlands present
☐ Floodplain (Zone: _______________)
☐ Steep slopes (>15%)
☐ Trees to be removed (number: _______)
☐ Endangered species habitat
☐ Historical/Archaeological resources
☐ Contamination/Prior industrial use
☐ None of the above

Environmental Review Status

☐ Exempt from environmental review
☐ Categorical Exemption/Exclusion (type: _______________)
☐ Negative Declaration/FONSI anticipated
☐ Environmental Impact Review required
☐ Review pending
☐ Unknown

Environmental Mitigation Proposed

_______________________________________________
_______________________________________________
_______________________________________________

SECTION 11: STANDARDS FOR APPROVAL

Address each standard required for conditional use permit approval:

1. Comprehensive Plan Consistency

Describe how the proposed use is consistent with the comprehensive plan/general plan:
_______________________________________________
_______________________________________________
_______________________________________________

2. Compatibility with Surrounding Area

Describe how the proposed use is compatible with adjacent land uses and the character of the neighborhood:
_______________________________________________
_______________________________________________
_______________________________________________

3. Adequate Public Facilities

Describe how adequate public facilities and services are available or will be provided:
_______________________________________________
_______________________________________________
_______________________________________________

4. Traffic and Access

Describe how the site provides adequate access and will not cause undue traffic congestion:
_______________________________________________
_______________________________________________
_______________________________________________

5. Public Health, Safety, and Welfare

Describe how the proposed use will not be detrimental to public health, safety, or welfare:
_______________________________________________
_______________________________________________
_______________________________________________

6. Additional Standards (if applicable)

Describe compliance with any use-specific standards:
_______________________________________________
_______________________________________________
_______________________________________________

SECTION 12: PROPOSED CONDITIONS

List any conditions the applicant proposes to mitigate impacts:

1. _______________________________________________
2. _______________________________________________
3. _______________________________________________
4. _______________________________________________
5. _______________________________________________

SECTION 13: STATE-SPECIFIC VARIATIONS

California

• Conditional Use Permit (CUP) governed by local ordinance under Government Code
• CEQA compliance required for all discretionary approvals
• Housing Accountability Act (HAB) may limit conditions on housing projects
• Permit Streamlining Act timelines apply (Gov. Code § 65950)
• Density bonus law (Gov. Code § 65915) may provide incentives

New York

• Special Use Permit or Special Exception terminology
• SEQRA environmental review required
• General Municipal Law procedural requirements
• Must make specific findings as required by enabling statute
• Variance vs. special permit distinction important

Texas

• Specific Use Permit (SUP) or Conditional Use Permit terminology
• Local Government Code Chapter 211 governs
• Property owner notification requirements
• No state environmental review requirement
• Vested rights protections may apply

Florida

• Special Exception or Conditional Use terminology
• Quasi-judicial hearing procedures required
• Florida Statutes Chapters 163, 166 govern
• Competent substantial evidence standard
• Bert Harris Act property rights protections

SECTION 14: REQUIRED ATTACHMENTS

Required for All Applications

☐ Application fee ($______________)
☐ Property deed or ownership documentation
☐ Owner authorization (if applicant is not owner)
☐ Site plan meeting submittal requirements (see checklist)
☐ Legal description of property
☐ Property survey (within _____ months)
☐ Adjacent property owner/occupant list
☐ Title report (within _____ days)

Site Plan Requirements

☐ Drawn to scale: _______________
☐ Property boundaries and dimensions
☐ Existing and proposed structures with dimensions
☐ Setback dimensions
☐ Parking layout with dimensions
☐ Access points and internal circulation
☐ Landscaping plan
☐ Lighting plan
☐ Utility connections
☐ Grading/drainage plan
☐ Signage locations

Additional Exhibits

☐ Floor plans
☐ Building elevations
☐ Perspective renderings
☐ Landscape plan
☐ Photometric plan
☐ Traffic impact analysis
☐ Environmental documentation
☐ Utility availability letters
☐ Market/demand study
☐ Operational plan/narrative
☐ Other: _______________________________________________

SECTION 15: CERTIFICATIONS AND SIGNATURES

Applicant Certification

I, the undersigned, certify that:

☐ All information in this application is true, complete, and accurate

☐ I have authority to file this application

☐ I have reviewed the applicable zoning regulations

☐ I understand the approval process and hearing requirements

☐ I authorize staff to enter the property for inspection

☐ I will comply with all conditions of approval

☐ I understand that approval may be revoked for non-compliance

Applicant Signature: ___________________________ Date: _______________

Printed Name: ___________________________

Property Owner Consent and Certification

I, the undersigned property owner, consent to this application and certify:

☐ I am the legal owner of the subject property

☐ I consent to the filing of this application

☐ I agree to be bound by conditions of approval

☐ I authorize the applicant to act on my behalf

Owner Signature: ___________________________ Date: _______________

Printed Name: ___________________________

FOR OFFICIAL USE ONLY

Application Number: _______________________________________________

Date Received: _______________________________________________

Received By: _______________________________________________

Fee: $_______________ Receipt #: _______________________________________________

Completeness Review:
☐ Complete as of: _______________
☐ Incomplete - deficiency letter sent: _______________

Environmental Review:
☐ Exempt (Class: _______________)
☐ Negative Declaration
☐ Mitigated Negative Declaration
☐ EIR/EIS Required

Referrals Sent:
☐ Public Works: _______________
☐ Fire Department: _______________
☐ Building Department: _______________
☐ Health Department: _______________
☐ Utilities: _______________
☐ Other: _______________

Public Hearing(s):
- Planning Commission: _______________________________________________
- City Council/Board: _______________________________________________

Action Taken:
☐ Approved
☐ Approved with Conditions
☐ Denied
☐ Continued to: _______________
☐ Withdrawn

Resolution/Ordinance Number: _______________________________________________

Conditions of Approval: ☐ Attached

Effective Date: _______________________________________________

Expiration Date: _______________________________________________

Appeal Deadline: _______________________________________________