ZONING PERMIT APPLICATION
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The undersigned, an owner or their representative, of the following described property do hereby apply for a Zoning Permit for the use indicated below. The applicant certifies that all information contained in the application is true and correct. The applicant is required to submit, in addition to the information in this application, a site plan drawing according to the specifications indicated on the site plan form. ZONING PERMITS WILL EXPIRE IF THE PROJECT IS NOT BEGUN WITHIN 6 MONTHS OR SUBSTANTIALLY COMPLETED WITHIN 1 YEAR.

Type of Permit (circle one)

New Dwelling R1 District
New Dwelling R2 District
New Dwelling R3 District
New Commercial
R1/R2 Residential Addition
R3 Residential Addition
Commercial Addition
Accessory Building
Fence
Sign
Swimming Pool
Deck
Telecommunications
Drainage

Location Description

Subdivision and Lot Number:__________________________________ Tax Parcel #______________________________

Property Address_____________________________________________________________________________________

Lot Size: Front Width________ Rear Width_______ Depth_________ Area (sq. ft.)___________________________

Type of Lot: Corner_____ Interior_____ Through_____ Present Zoning District______ Proposed Use________________

Proposed Structure Size: ________W x ________D x _________H Total Square Feet of Proposed Structure____________

Construction Type: Frame___ Brick___ Stone___ Proposed Use of Structure:___________________________________

Sign Type: Ground Mount/Single Face____ Ground Mount/Dbl Face___ Wall Sign___ Pole Mount___ Temporary_____

Fence Type: Chain Link___ Chain Link/Weaved___ Split Rail___ Privacy___ Wood Panel___

Drawings
Site plan drawings indicating the actual lot dimensions, shape of lot, size and location of existing structures along with the location and dimensions of the proposed structure shall be submitted with all zoning permit applications. Site Plan Requirements for R1/R2 Districts and/or for R3/B/M Districts indicate in detail the information required on the site plan drawing.

Applicant Information

Owner’s Name:______________________________________________________________________________________

Address:____________________________________________ City:_________________ State:_____ Zip Code________

Telephone:___________________________________________

Date Submitted:_______________________________________

Signature of Applicant:_______________________________________________________________________________
ANY ZONING PERMIT ISSUED UPON A FALSE STATEMENT OF ANY FACT WHICH IS MATERIAL TO THE ISSUANCE OF THE PERMIT SHALL BE VOID.
Village of Holland Official Use Only
Date Received:_____________ Amount of Fee Paid $_________ Receipt #_________ Permit #______
Date Reviewed:_____________ Approved:__________________ Denied:__________
If application is denied, state reasons for denial_____________________________________________________________

Issued by:__________________________________________________________________________
Zoning Administrator Date