Conditional Use Permit Application Form - Nebraska

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CONDITIONAL USE PERMIT
APPLICATION-FORM A
1. Applicant’s name
2. Applicant’s address
3. Telephone number (home)
(business)
4. Present use of property
5. Desired use of property
6. Request for Conditional Use Permit
Perpetual
Be issued for
years
7. Legal Description of property:
Street address and location
Legal Description
8. Area of subject property (sq. feet or acres)
9. Describe the general character of the area.
Signature of owner:
Signature of Authorized Agent:
309 N 5th Street; Norfolk, NE 68701
Rev: 05-2016
Return Completed forms to: Norfolk Planning Commission; 701 Koenigstein; Norfolk, NE 68701
Rev: 02-2004
Page 1 of 2
CONDITIONAL USE PERMIT
APPLICATION-FORM A
1. Applicant’s name
2. Applicant’s address
3. Telephone number (home)
(business)
4. Present use of property
5. Desired use of property
6. Request for Conditional Use Permit
Perpetual
Be issued for
years
7. Legal Description of property:
Street address and location
Legal Description
8. Area of subject property (sq. feet or acres)
9. Describe the general character of the area.
Signature of owner:
Signature of Authorized Agent:
309 N 5th Street; Norfolk, NE 68701
Rev: 05-2016
Return Completed forms to: Norfolk Planning Commission; 701 Koenigstein; Norfolk, NE 68701
Rev: 02-2004
Page 1 of 2
CONDITIONAL USE PERMIT
JUSTIFICATION-FORM B
1.
What is the present zoning?
2.
For what specific use are you requesting the permit?
Will it be necessary to build a new structure? Yes
No
3.
How is the proposed Conditional Use Permit compatible with adjacent properties?
4.
Give some reasons showing a need for the proposed use in this area
5.
Is screening or buffering required? Yes
No
If yes, explain the type
6.
Is the ingress and egress to the property and proposed structure adequate? Yes
No
If no, explain traffic flow solutions
7.
Are off-street parking and loading areas required? Yes
No
If yes, explain traffic flow
8.
How will the use affect traffic through residential areas or on adjacent major streets?
9.
Are any signs or exterior lighting required? Yes
No
If yes, explain
10. Are utilities property located? Yes
No
Explain location and closest availability
11. Is adequate sewer and water available as needed?
12. Will the required yards and other open spaces be observed with the permit?
Print
Reset
Return Completed forms to: Norfolk Planning Commission; 701 Koenigstein; Norfolk, NE 68701
309 N 5th Street; Norfolk, NE 68701
Rev: 05-2016
Rev: 02-2004
Page 2 of 2

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