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Planning & Zoning Department Planning & Zoning Department Planning & Zoning Department Planning & Zoning Department 152 East Ave A, Jerome, ID 83338 Phone (208) 324-8189 Email: [EMAIL REDACTED] Lot Combination Application Lot Combination Application Lot Combination Application Lot Combination Application Applicant Representative Name: Name: Address: Address: Phone/Cell: Phone/Cell: Email: Email: Lot #1 1. Parcel RPJ10702070041A- from tax information or the County Assessor’s Office) 2. Current Lot 3. Address of Lot (if Lot #2 1. Parcel RPJ10702070041A- from tax information or the County Assessor’s Office) 2. Current Lot 3. Address of Lot (if New Combined Lot 1. Lot 2. Legal Description of New Lot (attach) Zoning of Lots #1 and Residential 1 C1 Neighborhood Business M1 Light Industrial Residential 2 C2 General Business M2 Heavy Industrial Residential 3 C3 High Density Business Public/Semipublic Residential Multi-Family Central Business District Mixed Use Copy of deed showing ownership of lots 1 and 2 including legal description (Obtained from the County Clerk’s Office) Record of Survey: Shall be in conformance with Idaho Code, Title 55, Chapter 19 and contain additional information outlined in the Lot Combination Checklist. Other such information as may be deemed necessary by the Planning & Zoning Administrator. I hereby certify that I have familiarized myself with the rules and regulations with respect to preparing and filing this application, and that the information I have provided is accurate to the best of my belief. Signature / Printed Name of Owner of Lot #1 Date Signature / Printed Name of Owner of Lot #2 Date