VARIANCE / APPEAL APPLICATION

VARIANCE / APPEAL APPLICATION

2829 Minerva Lake Rd. Columbus OH 43231 614-882-5743 minervapark.gov
Type of Application

Variance ($50)Appeal ($100)
PLEASE NOTE: This application is not to be considered complete until all documents are received and approved by the Planning & Zoning Administrator
Project/Property Address or Location*
Project Name/Business Name (if applicable)
APPLICANT Name (primary contact) do not use a business name*
Applicant Address (if different from Property Address)
Applicant E mail*
example@example.com
Applicant Phone*
BUSINESS NAME (if applicable)
ATTORNEY/AGENT NAME (If applicable
ATTORNEY/AGENT CONTACT INFORMATION (if applicable)
ATTORNEY/AGENT EMAIL (If applicable)
example@example.com
PROPERTY OWNER NAME (if different than applicant)
PROPERTY OWNER PHONE (If different than applicant)
PROPERTY OWNER EMAIL (if different than applicant
APPLICANT SIGNATURE BELOW CONFIRMS THE SUBMISSION REQUIREMENTS HAVE BEEN COMPLETED (see page 2&3) - certify that the information on this application is complete and accurate to the best of my knowledge, and that the project as described, if approved, will be in accordance with the conditions and terms of that approval.
Applicant Signature*

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PLEASE PROVIDE A SUMMARY BELOW OF THE REASON YOU ARE REQUESTING THIS VARIANCE APPEAL (You may upload a file below if you prefer)*
if submitting a file below, please type "see attached" in the above box
IF YOU PREFER TO UPLOAD A DOCUMENT WITH YOUR SUMMARY (see above), PLEASE CLICK HERE

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FOR APPLICANT REVIEW/DISCUSSON WITH STAFF

1. Review Minerva Park Code

2. Survey of property by a registered surveyor (11"x17" copy)

3. List of contiguous property owners & their mailing address

4. A statement of the reason(s) for the variance request that address the following three conditions: Special circumstances or conditions: Necessary for preservation; Will not materially affect adversely for health or safety

5. Application fee

6. All supporting documents

7. Authorization Consent Form Complete
SITE PLAN (REQUIRED)*

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AUTHORIZATION TO VISIT PROPERTY-Must be completed by property owner

The owner or authorized owner's representative of the subject property listed on this application, hereby authorize City representatives to visit, photograph and post notice (if applicable) on the property as described in this application
PROPERTY OWNER
Type Name Here
Property Owner Signature*

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AGREEMENT TO COMPLY AS APPROVED-Must be completed by property owner

The applicant of the subject property listed on this application, hereby agrees that the project will be completed as approved and any proposed changes to the approved plan shall be submitted for the review and approval to Village staff.
APPLICANT
Type Name Here
Applicant Signature*

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AUTHORIZATION FOR OWNER'S APPLICANT OR REPRESENTATIVE(s):if the applicant is not the property owner, this section must be signed.

By typing the representative's name in the box and signing below, the signee authorizes the representative to act on the signees behalf, and agrees to be bound by all terms and agreements made by the designated representative.
REPRESENTATIVE NAME
Property Owner Signature

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STAFF USE ONLY-RESULTS OF VARIANCE / APPEAL
The Variance/Appeal is hereby DENIED on
The Variance/Appeal is hereby APPROVED on
Conditions
Planning & Zoning Commission
Authorized Representative
Date

MonthDayYear
Date
Filed and recorded by (signature)

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Check here if APPEALED. with higher courts.
Check here if APPEALED.Court document #
Court document #
Court Name
Payment Type

Credit/Debit Card: Select your product type and complete CC payment formCash/Checks may be mailed to/dropped off at 2829 Minerva Lake Rd. 43231

My Products

Variance

$50.00

Appeal

$100.00

Total

$0.00

Payment Methods

Credit Card

Apple Pay

Google Pay

STAFF USE ONLY-APPEAL/VARIANCE#
STAFF USE ONLY-PMT INFO; STAFF; DATE
Should be Empty:

VARIANCE / APPEAL APPLICATION

STAFF USE ONLY-RESULTS OF VARIANCE / APPEAL

Payment Methods