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Owner Name Parcel # - - Mailing Address For Office Use Only Permit # City Date Submitted State, Zip 60 Days Day Phone Fee Cell Phone Email Property Address Subdivision Twp Section______ Applicant Same as Owner Applicant Name Address 1 Address 2 City State, Zip Email Day Phone Clay County Planning & Zoning 3510 12th Ave S, PO Box 280 Moorhead, MN 56561-0280 Tel (218) 299-5005 Application Fee: $225.00 Interim Use Home Occupation Permit Application Rev 03/2021 ---PAGE BREAK--- Page 2 of 4 1. Describe the type of activity proposed to occur at the site: 2. How many square feet of floor space will be used for the activity: 3. Number of employees, other than yourself: 4. Is the activity of a temporary nature? ❑ Yes ❑ No 5. Describe the availability of parking for the proposed activity: 6. What will be the days and hours of operation for the proposed activity: 7. Review each of the following statements. Please circle YES or NO if the statement applies to your request. Each YES answer will need to be explained in detail in the space provided: A. Effect of Use: Will the request have an effect upon the health, safety, morals and general welfare of occupants of surrounding lands, existing and anticipated land uses, traffic conditions including parking facilities on adjacent streets and land, and the effect on agricultural usage and values of property and scenic view in the surrounding areas, and the effect of the proposed use on existing comprehensive plans? Yes No B. The requested use will not be injurious to the use and enjoyment of other property in the immediate vicinity and not diminish or impair property values within the vicinity? Yes No C. The requested use will not impede the normal and orderly development and improvement of surrounding vacant property for uses predominant in the area? Yes No ---PAGE BREAK--- Page 3 of 4 D. Measures have been or will be taken to provide utilities, access roads, drainage and off-street parking and loading spaces? Yes No E. Measures have been or will be taken to prevent or control offensive odor, fumes, dust, noise, vibration, water pollution and soil erosion, so that none of these will constitute a nuisance, and to control lighted signs or other lights in a manner that does not disturb neighboring properties? Yes No F. The use will not create an excessive burden on parks, schools, streets, water supply, sanitary sewers and storm sewers or other public facilities or utilities? Yes No G. The use will be compatible or separated by distance or screening from adjacent agriculturally zoned or used land so that existing homes will not be depreciated in value and will not deter agricultural use of said land: Yes No H. Will the structure or site have an appearance that will have an adverse effect upon adjacent residential properties? Yes No I. Is the use reasonably related to the overall needs of the zoning district and existing land use? In the case of flood plain areas, is there proof that the location is necessary and that alternative sites not susceptible to flooding are not available? Yes No J. Is the intended use consistent with the purposes of the Ordinance and for which the Applicant intends to locate the proposed use? Yes No K. Is the use in conflict with the comprehensive plan of any Township, City or County? Yes No L. Will the use cause traffic hazards or congestion and, in flood plain areas has access during flooding for ordinary and emergency vehicles? Yes No M. Will existing nearby businesses be adversely affected by curtailment of customer trade due to intrusion of noise, glare or general unsightliness? Yes No Detailed Explanation: (example F: proposed retail store will increase traffic on area roadways) ---PAGE BREAK--- Page 4 of 4 To the best of my knowledge, I certify that the information provided on this application and accompanying documents is true and accurate. Applicant signature: