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Page 1 of 3 APPLICANT PROPERTY OWNER Name: Name: Company: Company: Address: Address: City: City: State: Zip: State: Zip: Tel.: Tel: E-mail: E-mail: Property and Variance request information Site Adress: Lot: Block: Subdivision Name: Zoning: Total Acres: Tax Parcel Number: Floodplain: Yes No Existing Use: Surrounding Uses: Proposed Use: Description of the requested variance: Description and citation of Burley City Code land use requirements from which you are requesting a variance: How would strict compliance with the requirements of the land use provisions of the Burley City Code result in undue hardship because of unusual topography, other physical conditions or such other conditions which are not self-inflicted (a finding of undue hardship)? VARIANCE APPLICATION - Zoning regulations Permit Application Rec’d For Office Use Only THE CITY OF BURLEY ---PAGE BREAK--- Page 2 of 3 How will granting the variance not be detrimental to the public interest or welfare or injurious to other property in the area in which the property is situated? Describe how such variance will not violate any provisions of the Idaho Code. Describe how such variance would not have the effect of nullifying the interest and purpose of the Burley City Code land use requirements and the Comprehensive Plan. I consent to this application and hereby certify that information contained on the application and in the accompanying materials is correct to the best of my knowledge. I agree to be responsible for all application materials, fees, and application correspondence with the city. Signature of the applicant (date) Signature of the owner (date) APPLICATION INFORMATION REQUIRED Note: An electronic copy or hard copy of the entire application submittal is required. Incomplete applications will not be accepted. ONE COPY OF EACH CHECKLIST ITEM REQUIRED □ Compliance Statement and Statement of Intent □ Affidavit of Legal Interest □ Neighborhood Map □ Site Plan □ Approved Addresses □ Waiver Request of Application Materials (if applicable) ---PAGE BREAK--- Page 3 of 3 PLEASE CHECK THE FOLLOWING: Information for compliance statement and statement of intent: □ Should include purpose, scope, and intent of project □ Information concerning noxious uses, noise, vibration, and any other aspects of the use or structure that may impact adjacent properties or the surrounding community □ Statement explaining how the proposed use(s) is compliant with the standards of review for the proposed application. Cite the ordinances the proposed use(s) is compliant with Information required on neighborhood map: □ 8 ½ x 11 size minimum □ Location of contiguous lots and lot(s) immediately across from any public or private street, building envelopes and/or existing buildings and structures at a scale not less than one inch equals one hundred feet = 100’) Impact of the proposed siting on existing buildings, structures, and/or building envelope Information required on site plan: □ Scale not less than 1” = 20’) legend, and north arrow. □ Property boundary, dimensions, setbacks and parcel size □ Location of the proposed building, improvement, sign, fence or other structure and the relationship to the platted building envelope and/or building zone □ Building envelope dimensions with the center of the envelope location established in relation to the property lines □ Adjacent public and private street right of way lines □ Total square footage of all proposed structures calculated for each floor. If the application is for an addition or alteration to an existing building or structure, then the new or altered portions shall be clearly indicated on the plans and the square footage of new or altered portion and the existing building shall be included in the calculations □ For uses classified as drive-through, the site plan shall demonstrate safe pedestrian and vehicular access and circulation on the site and between adjacent properties. Information required for waiver request of application materials: □ Statement must include a list of the application materials to be waived and an explanation for the request