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Planning & Zoning Commission
Application for Rezoning
SECTION 1: APPLICANT INFORMATION
Name of Applicant:
Telephone Number:
Email Address:
SECTION 2: PROPERTY INFORMATION
Address:
Assessor's Parcel #:
Square Footage of Property:
Current Zoning:
Requested Zoning:
SECTION 3: AUTHORITY TO ACCESS PROPERTY
During the review process, City staff and the Planning & Zoning Commission may find it necessary to visit the property. Please select the one of the following:
☐ City staff and the Planning & Zoning Commission have my permission to enter upon the property
listed in Section 2 of this Application for Rezoning.
☐ City staff and the Planning & Zoning Commission do not have my permission to enter upon the
property listed in Section 2 of this Application for Rezoning.
SECTION 4: DOCUMENTS CHECKLIST
Attach the following items. Additional materials may be required during the review process. Failure to submit complete application materials may result in delays in processing; please
use the following checklist to confirm that your Application is complete:
☐ Legal description of the property.
☐ Location map of the property outlining the area to be rezoned.
☐ Names and addresses of all property owners within 200 feet of the property. (This information is
available from the County Assessor's office and/or website.)
☐ Applicant's statement as to why the zoning change is warranted, considering factors such as
compatibility with surrounding development, adequacy of public infrastructure and facilities,
compliance with the City's comprehensive plan and ordinances, etc.
☐ Application fee of $_______ [See FOIA request form for standard fees.]
SECTION 5: DISCLAIMER & CERTIFICATION
I, the undersigned, do hereby certify that the above and attached information is true and accurate to the best of my knowledge.
___________________________________________________________ __________________________________
Applicant Signature Date
For staff/commission use only:
SECTION 6: RECEIPT
Date Application received:
Legal description of the property received:
☐ Yes ☐ No
Location map of the property outlining the area to be rezoned received:
☐ Yes ☐ No
Names and addresses of all property owners within 200' of property received:
☐ Yes ☐ No
Applicant's statement received:
☐ Yes ☐ No
Date and amount of fee received:
For staff/commission use only:
SECTION 7: DISPOSITION
Date Application distributed to Commission:
Date public notice published in Quad City Times:
Date of mailing to all property owners within 200' of property:
Date hearing scheduled:
Disposition of hearing:
☐ Approve Request ☐ Deny Request - Chair: ___________________________________________________________
☐ Approve Request ☐ Deny Request - Vice Chair: ______________________________________________________
☐ Approve Request ☐ Deny Request - Member: _______________________________________________________
☐ Approve Request ☐ Deny Request - Member: _______________________________________________________
☐ Approve Request ☐ Deny Request - Member: _______________________________________________________
Commission Determination: ☐ Approve Request ☐ Deny Request
City of Riverdale, Iowa
110 Manor Drive, Riverdale, Iowa 52722 (563) 355-2511 www.riverdaleia.org
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