City of Hazleton Zoning Permit Application

City of Hazleton Zoning Permit Application
A Zoning Permit Application must be filed prior to the Building Permit Application

This application is being made for a permit to use land or a structure, or construct, alter, or demolish a structure in the location shown on the attached sketch plan. The information and the sketch plan that follow are considered part of this application. Any application which does not contain complete information, or all required documents will be returned to the applicant as incomplete and the applicant will be directed to provide the specific additional information needed for review. Pursuant to Zoning Ordinance, 2021-9, Chapter 11, section 1103 C., the Hazleton City Zoning Officer has thirty (30) days to review and make a decision on your zoning application. Any information, data or documents set forth in the application which are not true and correct, or which contain false, improper, or erroneous information, data, or documents, may result in revocation of any previously issued Zoning Permit or Approval.
Property Location and Ownership Information
Property Address and Location

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Deed Owner Name
Deed Owner Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Deed Owner Contact Number
Please enter a valid phone number.Format: (000) 000-0000.
Applicant Information, If Different Than Owner
Applicant Name
Applicant Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Applicant Contact Number
Please enter a valid phone number.Format: (000) 000-0000.
Interest in Property

Other
If you answered Other above, fill in a response below
Rental and Contractor Information
Rental Property
Current Number of Units
Proposed Number of Units
Rental Registration Up to Date
Driver’s License Attached
CONTRACTOR INFORMATION, IF SOMEONE OTHER THAN OWNER IS DOING THE WORK
Contractor Name
Contractor Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Contractor Contact Number
Please enter a valid phone number.Format: (000) 000-0000.
Pennsylvania Contractor Registration Number
Present Use of Property
Type of Use

Other
If you answered Other above, fill in a response below
Size and Type of Existing Lot
Existing Lot Width
Existing Lot Length/Frontage
Existing Lot Acres/Square Feet
Corner Lot
Number of Existing Buildings and Structures on Lot
Proposed Work

Type of Work, Structure and Use
Type of Work

Other
Type of Work - Other
Type of Structure

Other
Type of Structure - Other
Type of Accessory Structure
Type of Accessory Structure - Other
Type of Use

Other
Type of Use - Other
Description of the type of work/structure/use in detail
Site Plan

A site plan drawn to scale including the following must be attached to this application:(1) The exact size and location of existing and proposed structures on lot, including distances from structures to lot lines and other structures.(2) The number and type of structures on the lot.(3) The number and location of parking and loading spaces, if applicable.(4) The existing and proposed use of the lot.(5) The height of proposed structures.(6) The size and location of the lot and building setback lines and dimensions.(7) All streets and alleys bounding the lot.(8) All existing and proposed utilities, access drives, and easement, if any.
Site Plan Attachment

Cancelof
I will have the structure built and located in accordance with the dimensions in the attached plan.
Signature
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Zoning and Dimensional Information
Current Zoning District
Proposed Zoning District
Current Lot Size
Proposed Lot Size
Current Lot Width
Proposed Lot Width
Current Lot Depth
Proposed Lot Depth
Current Front Yard Setback (Front Yard (Street Name) *(Corner Lot) Other Front Yard Rear Yard SideYard (left side from front)Side Yard(right side from front)
Proposed Front Yard Setback Front Yard(Street Name)*(Corner Lot)Other Front Yard Rear Yard Side Yard (left side from front)Side Yard(right side from front)
Current Building Height
Proposed Building Height
Current Number of Off-street Parking Spaces
Proposed Number of Off-street Parking Spaces
Current Lot Coverage (%)
Proposed Lot Coverage (%)
Use Information - Check whichever is applicable
Please Explain
Size of Lot Area to be Used (sq. ft.)
Downtown Overlay District

If you answer YES to the questions below, you must obtain a Certificate of Appropriateness (COA) and include it with your application.
Is the property located within the Downtown Overlay District (see map located in code office). The district boundary encompasses both sides of Broad Street between Locust and Poplar Streets, both sides of Church Street between Broad and Maple Streets, both sides of Laurel Street between Broad and Maple Streets; and both sides of Wyoming Street between Broad and Holly Streets.
Will the proposed scope of work impact the front exterior of the building.
Other Construction Information
Has a sewer and water connection permit been obtained? (If a permit has been obtained, attach a copy to this application.
Sewer and Water Connection Permit

Cancelof
Start Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Completion Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Construction Costs ($)
Signatures

By signing below,the applicant and owner verify that the information contained in this application and the documents attached are true and correct to the best of his/her/their knowledge,information and belief. The applicant and owner understand that false statements made herein are subject to penalties of 18Pa.C.S.A. Section 4904 relating to unsworn falsification to authorities. If the application is not signed by the owner, the applicant certifies that the applicant is authorized by the owner to make this application and the applicant agreed to inform the owner of the approval (with conditions if any) or denial of the application.
Owner Signature
Owner Signature Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Applicant Signature
Applicant Signature Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
FOR CODE ENFORCEMENT OFFICE USE ONLY
Appl. #: ZA/
Date Issued:
By:
Date Returned:
Status:
Fees

Comm./Id. Use $125Residential Use $75
Should be Empty:

City of Hazleton Zoning Permit Application

Property Location and Ownership Information

Applicant Information, If Different Than Owner

Rental and Contractor Information

CONTRACTOR INFORMATION, IF SOMEONE OTHER THAN OWNER IS DOING THE WORK

Present Use of Property

Size and Type of Existing Lot

Proposed Work

Site Plan

I will have the structure built and located in accordance with the dimensions in the attached plan.

Zoning and Dimensional Information

Downtown Overlay District

Other Construction Information

Signatures

FOR CODE ENFORCEMENT OFFICE USE ONLY

Fees