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Walton County Planning and Development SUBMITTAL CHECKLIST For Conditional Use Application Application must be completely filled out. Name, address and phone number of all owners of the property. (if more than one owner-attach as exhibit) Recorded Deed of property Recorded Plat of property Campaign contribution form Authorization to file if applicant is not the owner. (must be notarized) Written documented, detailed analysis of the impact of the proposed zoning map amendment with respect to each of the standards and factors in Article 4, Part 4, Section 160 1 reduced copy of site plan (11X17) Letter of intent with any conditions Proof of Property Taxes paid on property. INCOMPLETE APPLICATIONS WILL NOT BE ACCEPTED ---PAGE BREAK--- Conditional Use Application Planning Comm. Meeting Date 6:00PM held at WC Board of Comm. Meeting Room Board of Comm Meeting at 6:00PM held at WC Historical Court House You or a representative must be present at both meetings ***Please Type or Print Legibly*** Applicant Name/Address/Phone # Property Owner Name/Address/Phone (If more than one owner, attach Exhibit Phone Phone Present Zoning Acreage_______ Existing Use of Existing Property is serviced by: Public Public Septic The purpose of this conditional use is: The above statements and accompanying materials are complete and accurate. Applicant hereby grants permission for planning and zoning personnel to enter upon and inspect the property for all purposes allowed and required by the Comprehensive Land Development Ordinance. Signature Date Fee Paid Public Notice sign will be placed and removed by P&D Office Signs will not be removed until after Board of Commissioners meeting Office Use Only: Existing Zoning_________ Surrounding Zoning: Comprehensive Land Commission District: Watershed: I hereby withdraw the above ---PAGE BREAK--- Standard Review Questions: Provide a written, documented, detailed analysis of the impact of the proposed zoning map amendment or conditional use with respect to each of the standards and factors specified in Section 160 listed below: Conditional Use Permit Criteria 1. Adequate provision is made such as setbacks, fences, etc., to protect adjacent properties from possible adverse influence of the proposed use, such as noise, dust vibration, glare, odor, electrical disturbances, and similar factors. 2. Vehicular traffic and pedestrian movement on adjacent streets will not be hindered or endangered. 3. Off-street parking and loading and the entrances to and exits from such parking and loading will be adequate in terms of location, amount and design to serve the use. 4. Public facilities and utilities are capable of adequately serving the proposed use. 5. The proposed use will not adversely affect the level of property values or general character of the area. ---PAGE BREAK--- Disclosure of Campaign Contributions In accordance with the Conflict of Interest in Zoning Act, O.C.G.A., Chapter 36-67A, the following questions must be answered: Have you the applicant made $250 or more in campaign contributions to a local government official within two years immediately preceding the filing of this application? no If the answer is yes, you must file a disclosure report with the governing authority of Walton County showing: 1. The name and official position of the local governing authority in Walton County to whom the campaign contribution was made. 2. The dollar amount and description of each campaign contribution made during the two years immediately preceding the filing of this application and the date of each such contribution was made. This disclosure must be filed when the application is submitted. Signature of Applicant/Date Check one: ---PAGE BREAK--- AUTHORIZATION BY PROPERTY OWNER I swear that I am the property owner of the property which is the subject matter of the attached Petition for Rezoning/Conditional Use Application, as is shown in the records of Walton County, Georgia. I authorize the named below to act as Applicant in the pursuit of a Petition for Rezoning/Conditional Use Application. Name of Applicant: Address: Telephone: Location of Property: Map/Parcel Number: Current Zoning: Requested Property Owner Signature Property Owner Signature Print Print Phone Phone Personally appeared before me and who swears that the information contained in this authorization is true and correct to the best of his/her knowledge. Notary Public Date