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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. Parcel #:
10. Subdivision:
11. Lot #:

    (Or attach legal description)

13. Zoning District:
14. Flood Plain Zone:
    -- Select One --YESNODON'T KNOW
16. Project Type:*
    -- Select One --New TenantNew Owner of Existing Business
18. Former Tenant/Business Name*
20. Description of Former Use: *
22. New Tenant/Business Name:*
24. Description of New Use: *
26. Property Owner's Name:*
28. Property Owner's Phone No:*
29. Property Owner's Email:*
31. Property Owner's Address:*
32. Address 2:
34. City*
35. State*
36. Zip*
38. Applicant Name:*
40. Applicant Address:*
41. Applicant Address2:
43. City*
44. State*
45. Zip*
47. Phone No:*
48. Applicant Email:*
50. Signature: *

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

52. Applicant is:*
    -- Select One --OwnerTenantOwner's AgentOther
53. OTHER:
57. Office Use Only:

    □ APPROVED    □ DENIED 

    REVIEWER SIGNATURE DATE:___________________

    REVIEWER COMMENTS:_________________________________________________________________________________________________

    _____________________________________________________________________________________________________________

61. INSTRUCTIONS TO APPLICANTS

    A commercial zoning clearance application for new ownership or new tenant must include the following items:

        Completed Zoning Clearance - Easy Form

        Site plan showing business location & parking spaces (no smaller than 1’ = 50’ scale)

        Appropriate fees (see current fee schedule)

63. Attach any and all required documents:

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

Leave This Blank:


64. 1. Receive an email copy of this form.
65. Email address

    This field is not part of the form submission.

66. Submit

* indicates a required field