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H:\PLANNING\FORMS\Applications\July 2016\Development Review Application.doc DEVELOPMENT REVIEW APPLICATION Community Development Department Planning Division 10890 San Pablo Avenue, El Cerrito, CA 94530 (510) 215-4330 – FAX (510) 233-5401 [EMAIL REDACTED] Application No: Date Received: Please discuss your proposal with Planning Staff prior to completing this form. Please print or type legibly. Attach additional sheets if necessary. Incomplete applications may not be accepted. 1. Type of Application Use Permit Administrative Use Permit Temporary Use Permit Variance Lot Line Adjustment Certificate of Compliance Tentative Map (Minor) Tentative Map (Major) Parcel Map Zoning Clearance Accessory Dwelling Unit Design Review SPASP Tier I SPASP Tier II SPASP Tier III SPASP Tier IV Administrative Design Review RAD Review Planned Development Zoning Amendment/Rezone General Plan Amendment SB-9 Project Application Fee(s): Fee(s): Pub. Notice: $0.56 x = (1700) Mail List: (6055) Env. Fee: (6053) Laserfiche: Total: 2. Property Location: Zoning District: APN: Address of Subject Property: 3. Requested Action: 4. Applicant: In signing this application, I, as Applicant, certify that I have obtained written authorization from the property owner and have attached separate documentation showing my full legal capacity to file this application. I agree to be bound by the conditions of approval, subject only to the right to object at the public hearings or during the appeal period. I further certify that the information and exhibits submitted are true and correct. Applicant’s Name: Contact Person: Address: Zip: Applicant’s Phone: ( ) Contact Person’s Phone: ( Fax: ( ) Email Address: Signature: 5. Property Owner: In signing this application, I, as Property Owner, certify that I have full legal capacity to, and hereby do, authorize the filing of this application. I understand that conditions of approval are binding. I agree to be bound by those conditions, subject only to the right to object at the public hearings or during the appeal period. I further certify that the information and exhibits submitted are true and correct. Note: all property owners must sign if property is jointly owned. Name: Address: Zip: Phone: ( ) Fax: ( ) Email Address: Signature: APPLICANT AGREES TO HOLD THE CITY OF EL CERRITO (CITY) HARMLESS FOR ALL COSTS AND EXPENSES, INCLUDING ATTORNEY’S FEES, INCURRED BY THE CITY OR HELD TO BE THE LIABILITY OF THE CITY IN CONNECTION WITH THE CITY’S DEFENSE OF ITS ACTIONS IN ANY PROCEEDING BROUGHT IN ANY STATE OR FEDERAL COURT CHALLENGING THE CITY’S ACTIONS WITH RESPECT TO THE APPLICANT’S PROJECT. SIGN SIGN