Application to erect / alter / change a Building

APPLICATION FOR REVIEW

(One Form must be filled out for each structure on each Lot)
I / We hereby apply for permission to * the use of a * in accordance with the following information and as shown on the accompanying drawings.
1. Name of Project Owner:*

First NameLast Name
Address*

House No. and Street

Street Address Line 2

City / Town / VillageDistrict

Postal / Zip Code
Telephone*
Please enter a valid phone number.
Email*
example@example.com
2. Legal Description (street address or similar description that will readily identify, and definitively locate the proposed building or work.)
Parcel Number
Block Number
Lot Number
Land Registration Section
Address*

House No. and Street

Street Address Line 2

City / Town / VillageDistrict

Postal / Zip Code
Legal owner of property*
3. Parcel Measurement:
Front:*
Back:*
Right Side:*
Left Side:*
4. Zoning:*

UrbanRural
i. Building Use:

ResidentialCommercialIndustrialInstitutionalAmenitiesGovernment
ii. Land Use:

ResidentialCommercialIndustrialInstitutionalAmenitiesGovernment
5. Occupancy:
Estimated number of occupants: (this will be reflected on Occupancy Certificate)
a) Residents
b) Staff
c) Patrons
d) Visitors
e) Total Occupancy Loading
6. Building description:
i. Dimensions of building(s):
Length:*
Width:*
ii. Number of proposed building(s):*
ii. Number of floors:*
iii. Max. height of building(s):*
v. The following number of parking spaced are provided within property boundaries. (To be indicated on drawing also):
Total Parking Spaces Provided:*
a) Front:*
b) Right Side:*
c) Left Side:*
d) Back:*
7. The water supply will be by:

Belize Water ServicesCisternWater TankWellPublic Water Reservoir
8. The sewage will be disposed by:

SepticSewerWaste Water Treatment (Specify Type)
9. Electricity supply will be provided by:

BELGeneratorSolar Panel
10. Technicians, Architects and/or Engineers of Record:

I, the undersigned accept full responsibility for the correctness of the Technical Information submitted on this Application Form, I also accept full responsibility for the correctness and suitability of the information provided in the other documents submitted along with this Application Form.
1. Name of Technician (Please place N/A if not applicable)*

First NameLast Name
Address

House No. and Street

Street Address Line 2

City / Town / VillageDistrict

Postal / Zip Code
Signature

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OR Upload a Digital Signature

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2. Name of Architect (Please place N/A if not applicable)*

First NameLast Name
Address

House No. and Street

Street Address Line 2

City / Town / VillageDistrict

Postal / Zip Code
Signature

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OR Upload a Digital Signature

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3. Name of Engineer (Please place N/A if not applicable)*

First NameLast Name
Address

House Number and Street Address

Street Address Line 2

City / Town / VillageDistrict

Postal / Zip Code
Signature

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OR Upload a Digital Signature

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Name of permittee or his authorized agent:*

First NameLast Name
Address of permittee or his authorized agent:*

House Number and Street Address

Street Address Line 2

City / Town / VillageDistrict

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Cell Number*
Please enter a valid phone number.
Email Address*
example@example.com
Signature of permittee or his authorized agent

Clear
OR Upload a Digital Signature

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Date Submitted*

MonthDayYear
Date
Upload Documents*

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Proof of Payment*

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Should be Empty:

APPLICATION FOR REVIEW