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Application for Zoning Permit

St Albans Township, Ohio

Property Location Zoning District Property Owner Mailing Address Cell Business number Existing Use

Type of Zoning Requested:

Lot Width (Ft) Lot Depth (Ft) Lot Area (Acres) Corner Lot

Dwelling/Commercial/Industrial:

First Floor (SqFt) Second Floor (SqFt) Additional Floor (SqFt)

Basemement(SqFt) Garages (SqFt) Number of Stories

Accessory Building: Total (SqFt) Number of Stories Height

Sign: Temporary Permanent Billboard

Front Side (SqFt) Back Side (sqFt) Height (Ft) Sign Setback (Ft)

District Required Yard/Setbacks (Ft) for Structure:

Front(From R/W) Back Sides

Number of Off-Street Parking Spaces to be Provided Number of Off-Street Loading Berths to be Provided Is this property located in an identified flood plain?

On a separate sheet attach a list of other supplemental requirements or conditions that will be met, or explain points you feel needs clarification.

This permit shall be void if work it not started within one year or completed within 2 ½ years. By signing below, you certify that a Summary of residential work that does or does not require approval through the Licking County Building Code Dept has been given to you.

Applicant Signature Date

Zoning Signature Date Permit#