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2. Office Use Only

   Flood Hazzard Zone    Y  /  N

   Wellhead Protection Zone    Y  /  N

   Historic Overlay District    Y  /  N

3. Permit #______________________________

   Date submitted:________________________

7. Site/Project Address:*
9. Lot #:

   (Or attach legal description)

10. Parcel #:*
11. Subdivision:
13. Zoning District:
14. Flood Plain Zone:
    -- Select One --YESNODON'T KNOW
15. Development permit #:
17. Description of Existing Use:*
19. Description of Proposed Use: *
21. Project Type:*
    -- Select One --New ConstructionAlterationSubstantial Improvement Other
23. Project Description: *

    Type of work, proposed uses, square footage of all structures, etc.

25. Is this an alteration to a structure that existed on October 27, 1938?
    -- Select One --YESNO
26. On August 1, 2001?
    -- Select One --YESNO
27. On September 13, 2023?
    -- Select One --YESNO
29. Property Owner's Name:*
31. Property Owner's Address:*
32. Property Owner's Address2:
34. City*
35. State*
36. Zip*
38. Property Owner's Phone No:*
39. Property Owner's Email:*
41. Design Professional:*
    -- Select One --ArchitectEngineerContractor
43. Design Professional/Contractor Name:*
45. Address:*
46. Address2:
48. City*
49. State*
50. Zip*
52. Phone No.*
53. Email:*
55. Applicant Name:*
57. Applicant Address:*
58. Applicant Address2:
60. City*
61. State*
62. Zip*
64. Phone No:*
65. Applicant Email:*
67. Signature: *

    BY SIGNING THIS FORM, I HEREBY CERTIFY THAT THE FOREGOING STATEMENTS AND ATTACHMENTS ARE TRUE AND ACCURATE.

69. Applicant is:*
    -- Select One --OwnerTenantOwner's AgentOther
70. OTHER:
74. Office Use Only:

    □ APPROVED    □ DENIED 

    REVIEWER SIGNATURE DATE:___________________

    REVIEWER COMMENTS:____________________________________________________________________________________________

    _______________________________________________________________________________________________________

78. Commercial Zoning Clearance Application Requirements:

    Commercial zoning clearance applications shall include the following information as applicable:

    A. Site Plan (drawn to scale)

        Legal description

        North arrow

        Actual shape and dimensions of the property including frontage, depths, lot area in square feet, density of units per acre

        Location and dimensions of all easements

        Location, dimension, and height of existing and proposed buildings or structures on the property

        Distance between lot lines and existing and proposed structures

        Proposed use(s) for each building, structure, or portion of the lot(s)

        Number of proposed dwelling units – indicate use and dimensions of each room

        Total pervious and impervious areas

        Pavement composition

        Vehicular use layout including direction of flow, stacking, location and dimensions of driveways, drive aisles, curbs, curb cuts, curb ramps, sidewalks, and wheel stops

        Number of existing and proposed parking spaces, loading spaces, and handicapped spaces with dimensions

        Dumpster location, screening, and drainage detail

        Existing and proposed landscaping – interior and perimeter

        Fence location, height, material, distance from lot lines

        Existing or proposed signage location, dimensions, height, and illumination levels

    B. Elevation Drawings

        Building scale and massing

        Exterior finish materials – indicate percentage of natural materials

        Entries, doors, and windows

        Trim and architectural detailing

        Mechanical equipment

    C. Landscape Plan

       Proposed landscaping including botanical and common name of plantings, installation size, on-center planting dimensions and quantities

    D. Lighting Plan

        Photometric plan showing lighting levels in relation to buildings, pedestrian pathways, vehicular use areas, and lot lines

        Cut sheets showing style, height, and design detail of all luminaires

    E. Pedestrian & Connectivity Study (stamped by Professional Engineer)

        Study showing all existing pedestrian and bicycle accommodations within 0.25-mile buffer around entire site including sidewalks, crosswalks, pedestrian signals, pedestrian push buttons, bike lanes and trails, sidewalk buffers, on-street parking, medians, and transit stops within the study area

80. Attach any and all required documents:

    Or email to buildingsubmittal@ci.lancaster.oh.us or building@ci.lancaster.oh.us

Leave This Blank:


81. 1. Receive an email copy of this form.
82. Email address

    This field is not part of the form submission.

83. Submit

* indicates a required field