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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:________________________

5. There are no fees required for the Residential Zoning Clearance.

   A site plan is required for this application.  Can be added below or emailed.

9. Site/Project Address:*
11. Parcel #:
12. Lot #:

    (Or attach legal description)

13. Subdivision:
15. Zoning District:
16. Flood Plain Zone:
    -- Select One --YESNODON'T KNOW
18. Project Type:*
    -- Select One --New Single FamilyAddition/AlterationAccessory BuildingOther
20. Project Description: *

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

22. Is this an alteration to a structure that existed on October 27, 1938?
    -- Select One --YESNO
23. On August 1, 2001?
    -- Select One --YESNO
24. On September 13, 2023?
    -- Select One --YESNO
26. Property Owner's Name:*
28. Property Owner's Address:*
29. Property Owner's Address2:
31. City*
32. State*
33. Zip*
35. Owners Phone No:*
36. Owners Email:*
38. Contractor Name:
40. Phone No.
41. Contractor Email:
43. Applicant Name:*
45. Applicant Address:*
46. Applicant Address2:
48. City*
49. State*
50. Zip*
52. Phone No:*
53. Applicant Email:*
55. Signature: *

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

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

    □ APPROVED    □ DENIED 

    REVIEWER SIGNATURE DATE:___________________

    REVIEWER COMMENTS:_________________________________________________________________________________________________

    _____________________________________________________________________________________________________________

66. Attach any and all required documents: *Site Plan is Required

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

70. Residential zoning clearance applications shall include the following information as applicable:
72. NEW SINGLE-FAMILY CONSTRUCTION:

    A. Plot & Grading Plan

        Subdivision

        Lot Number for lot and surrounding lots

        Scale

        North arrow

        Drawing of lot & improvements with dimensions   

              i. Existing & proposed structures

              ii. Drive & sidewalks

        Easements including dimensions

        Street names

        Street right of way width

        Flood Zone Determination

        Building setback lines

        Sanitary Sewer location and appurtenances

        Sanitary Wye location and elevation of Wye

        Storm Sewer location and appurtenances

        Water Line location and appurtenances

         Proposed ground elevations

                i. property corners

                ii. building corners

                iii. curb cut

                iv. swales

        Storm water routing arrows

        House number

        Intersecting streets & right of way

        Floor elevations

                i. finished floor

                ii. top of block

                iii. basement

        Certification (when required)

    B. Elevation Drawings – refer to architectural requirements found in LCO 1147.03

        Building scale and massing

        Exterior finish materials and specific percentage of natural materials

        Entries, doors, and windows

        Trim and architectural detailing

        Mechanical equipment

73. ALL OTHER RESIDENTIAL PROJECTS:

    A. Site Plan

        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)

        Total pervious and impervious areas

        Pavement composition

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

    B. Elevation Drawings

        Building scale and massing

        Exterior finish materials and specific percentage of natural materials

        Entries, doors, and windows

        Trim and architectural detailing

        Mechanical equipment

Leave This Blank:


74. 1. Receive an email copy of this form.
75. Email address

    This field is not part of the form submission.

76. Submit

* indicates a required field