TEMPORARY USE PERMIT APPLICATION
TEMPORARY USE PERMIT APPLICATION
240 East Gammon Road Vineyard, Utah 84058 (801) 226-1929
Please Note: Attachment of request specific documents is required prior to processing your application. APPLICATION DATE: _______________________________ APPLICANT(S): ADDRESS OF APPLICANT:
BUSINESS PHONE #:
CELL PHONE #:
EMAIL ADDRESS:
FAX NUMBER:
CURRENT ZONING DISTICT DESIGNATION: NUMBER OF PROPOSED NEW LOTS: LOCATION/ADDRESS OF PROPOSED FINAL SUBDIVISION:
TOTAL ACREAGE OF PROPOSED FINAL SUBDIVISION: NAME OF PROPERTY OWNER(S):
CHECK APPLICABLE PERMIT ATTACHMENT: CONDITIONAL USE PERMIT
FINAL PLAT
GENERAL MAP/PLAT AMENDMENT
LAND DISTURBANCE PERMIT
MINOR PLAT AMENDMENT
PERMITTED USE SITE PLAN
PRELIMINARY SUBDIVISION
ROAD CUT PERMIT
TEMPORARY USE PERMIT
VARIANCE APPLICATION
SIGNATURE OF APPLICANT(S):
Applicant Signature
Co-Applicant Signature
Page 1 of 3
/
/
Date
Date
/
/
Updated 12/21/2012
OFFICE USE ONLY DATE RECEIVED Initial Submittal Complete Submittal Type of Request
Staff Comments:
Amount Due
Date Paid
DATE OF APPROVALS Town Council
Planning Commission
PAYMENT INFORMATION Amount Paid
Check #
Only fully completed submittals may be accepted in office. If the submittal is incomplete in any way, it must be returned to the applicant. Temporary Application Requirements Checklist
□ A Completed Temporary Use Application Form, as provided by the Town of Vineyard. □ Two (2) 11” x 17” size copy of a Site Plan, identifying the location of all proposed uses, buildings, and structures, as well as the following: a) The location and dimension of the property boundaries and all proposed uses, buildings and structures, as well as all existing buildings or structures located on the property.
b) The setback requirements, as required by the Zoning District in which the proposed uses, buildings, and structures are located, as well as the exterior dimensions of all proposed buildings and structures. c) The location of all roads and streets serving the property, or proposed to serve the property, including any Permits as required by Utah County or the Utah Department of Transportation, as applicable. d) The location and dimension of all existing and proposed ingress and egress points and off-street parking. e) Additional plans and drawings, as may be applicable. / Applicant Signature
/ Date
/ Applicant Signature
/ Date
VINEYARD APPROVAL: / Town Approval Signature
/ Date
OFFICE USE ONLY DATE APPLICATION RECEIVED
PAYMENT RECEIVED
AMOUNT PAID
CHECK #
FEE: $75.00
Page 2 of 3
Updated 12/21/2012
PROPERTY OWNER AFFIDAVIT STATE OF UTAH COUNTY OF UTAH}
} }ss
I, _____________________________________________________________, the undersigned and owner(s) of the property identified in the attached application, depose that the statements herein contained in this application and the information provided in the attached plans and exhibits are in all respects true and correct to the best of my knowledge. _____________________________________________________ (Property Owner) _____________________________________________________ (Property Owner) Subscribed and sworn before me, ________________________________________, a Notary Public, on this ________ day of _______________, 20______. ____________________________________________________ (Notary Public) My commission expires: ________________________________
AGENT AUTHORIZATION AFFIDAVIT I, ______________________________________________________________, the undersigned and owner(s) of the real property described in the attached application, do authorize ___________________________________________________________________________, as agent(s) and designated representative(s) regarding the attached application, to appear on my behalf before any administrative or legislative body in the Town of Vineyard considering this application, and to act in all respects as agent(s) in matters pertaining to the attached application. ______________________________________________________ (Property Owner) ______________________________________________________ (Property Owner) Dated this _________day of _________________, 20 ______, personally appeared before me ___________________________________________________________________________, the signer(s) of the agent authorization who duly acknowledged to me that they executed the same. _____________________________________________________ (Notary Public) My commission expires: _________________________________
Page 3 of 3
Updated 12/21/2012
240 East Gammon Road Vineyard, Utah 84058 (801) 226-1929
Please Note: Attachment of request specific documents is required prior to processing your application. APPLICATION DATE: _______________________________ APPLICANT(S): ADDRESS OF APPLICANT:
BUSINESS PHONE #:
CELL PHONE #:
EMAIL ADDRESS:
FAX NUMBER:
CURRENT ZONING DISTICT DESIGNATION: NUMBER OF PROPOSED NEW LOTS: LOCATION/ADDRESS OF PROPOSED FINAL SUBDIVISION:
TOTAL ACREAGE OF PROPOSED FINAL SUBDIVISION: NAME OF PROPERTY OWNER(S):
CHECK APPLICABLE PERMIT ATTACHMENT: CONDITIONAL USE PERMIT
FINAL PLAT
GENERAL MAP/PLAT AMENDMENT
LAND DISTURBANCE PERMIT
MINOR PLAT AMENDMENT
PERMITTED USE SITE PLAN
PRELIMINARY SUBDIVISION
ROAD CUT PERMIT
TEMPORARY USE PERMIT
VARIANCE APPLICATION
SIGNATURE OF APPLICANT(S):
Applicant Signature
Co-Applicant Signature
Page 1 of 3
/
/
Date
Date
/
/
Updated 12/21/2012
OFFICE USE ONLY DATE RECEIVED Initial Submittal Complete Submittal Type of Request
Staff Comments:
Amount Due
Date Paid
DATE OF APPROVALS Town Council
Planning Commission
PAYMENT INFORMATION Amount Paid
Check #
Only fully completed submittals may be accepted in office. If the submittal is incomplete in any way, it must be returned to the applicant. Temporary Application Requirements Checklist
□ A Completed Temporary Use Application Form, as provided by the Town of Vineyard. □ Two (2) 11” x 17” size copy of a Site Plan, identifying the location of all proposed uses, buildings, and structures, as well as the following: a) The location and dimension of the property boundaries and all proposed uses, buildings and structures, as well as all existing buildings or structures located on the property.
b) The setback requirements, as required by the Zoning District in which the proposed uses, buildings, and structures are located, as well as the exterior dimensions of all proposed buildings and structures. c) The location of all roads and streets serving the property, or proposed to serve the property, including any Permits as required by Utah County or the Utah Department of Transportation, as applicable. d) The location and dimension of all existing and proposed ingress and egress points and off-street parking. e) Additional plans and drawings, as may be applicable. / Applicant Signature
/ Date
/ Applicant Signature
/ Date
VINEYARD APPROVAL: / Town Approval Signature
/ Date
OFFICE USE ONLY DATE APPLICATION RECEIVED
PAYMENT RECEIVED
AMOUNT PAID
CHECK #
FEE: $75.00
Page 2 of 3
Updated 12/21/2012
PROPERTY OWNER AFFIDAVIT STATE OF UTAH COUNTY OF UTAH}
} }ss
I, _____________________________________________________________, the undersigned and owner(s) of the property identified in the attached application, depose that the statements herein contained in this application and the information provided in the attached plans and exhibits are in all respects true and correct to the best of my knowledge. _____________________________________________________ (Property Owner) _____________________________________________________ (Property Owner) Subscribed and sworn before me, ________________________________________, a Notary Public, on this ________ day of _______________, 20______. ____________________________________________________ (Notary Public) My commission expires: ________________________________
AGENT AUTHORIZATION AFFIDAVIT I, ______________________________________________________________, the undersigned and owner(s) of the real property described in the attached application, do authorize ___________________________________________________________________________, as agent(s) and designated representative(s) regarding the attached application, to appear on my behalf before any administrative or legislative body in the Town of Vineyard considering this application, and to act in all respects as agent(s) in matters pertaining to the attached application. ______________________________________________________ (Property Owner) ______________________________________________________ (Property Owner) Dated this _________day of _________________, 20 ______, personally appeared before me ___________________________________________________________________________, the signer(s) of the agent authorization who duly acknowledged to me that they executed the same. _____________________________________________________ (Notary Public) My commission expires: _________________________________
Page 3 of 3
Updated 12/21/2012
