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152 East Ave A, Jerome, ID 83338 Phone: (208) 324-8189 Ext. 140 [EMAIL REDACTED] www.cityofjerome.org PLANNING AND ZONING APPLICATION Request Type ☐ Special Use Permit ☐ Annexation ☐ Variance ☐ Rezone ☐ Subdivision Preliminary Plat ☐ Subdivision Final Plat ☐ Zoning Ordinance Amendment ☐ $75 filing fee is required with complete application. Preliminary and final plats are a $150 fee plus $1.00 for each proposed lot in the subdivision. Applicant Information Applicant Name: Mailing Address: Physical Address: Telephone Number: Email: Legal Description: Current Use of Property Current Zoning: Ownership ☐ I am the recorded owner of the property. ☐ I am the purchaser thereof, under a contract in writing. ☐ I am the lessee or the agent authorized. By signature hereon, the property owner acknowledges that City officials and/or employees may, in the performance of their functions, enter upon the property to inspect, post legal notices, and/or other standard activities in the course of processing this application, pursuant to Idaho Code §67- 6507. The lessee or agent has my permission act on. Property Owner’s Signature: / SIGN ---PAGE BREAK--- Write a complete description of your request: Notification of adjacent property owners: signature of an adjacent property owner is not an approval or denial of your request but acknowledgment that you notified them of your request. 500 feet, property zoned Residential - 1, 2, 3, or Multi-Family Residential 750 feet, property zoned General Business High Density Business or Central Business District (CBD) 1,000 feet, property zoned Neighborhood Business (C-1) 1,500 feet, if property is zoned Public/Semi Public (PS), Mixed Use (MU) , Light Industrial (M-1) or Heavy Industrial 2) Applicant Signature AT ITS OPTION, THE JEROME CITY PLANNING AND ZONING COMMISSION MAY, UPON NOTICE AND HEARING, AND WITH GOOD CAUSE APPEARING THEREFORE, REVOKE A ZONING AMENDMENT IF THE TERMS THEREOF ARE BEING VIOLATED. I hereby certify that I am the applicant named herein, and that I have familiarized myself with the rules and regulations with respect to preparing and filing this application, and that the foregoing statements and answers herein contained, and the information on the attached maps, are in all respects true and accurate to the best of my belief. Printed Name: Signature: Date: Appeals: Any interested party may appeal in writing any final decision of the Planning and Zoning Administrator, or Commission to the City Council by filing an appeal with the Jerome City Clerk within fifteen (15) days from the date of the decision. The appeal shall specifically state the decision appealed and reasons for the appeal. If no appeal is filed within the fifteen (15) day period, the decision shall be deemed final.