TOWN OF TIBURON

LAND DEVELOPMENT APPLICATION

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TYPE OF APPLICATION

O Conditional Use Permit O Design Review (Major) O Tentative Subdivision Map
O Precise Development Plan O Design Review (Minor) O Final Subdivision Map
O Conceptual Master Plan O Variance  O Parcel Map
O Rezoning/Prezoning O Sign Permit O Lot Line Adjustment
O Zoning Text Amendment O Tree Permit O Certificate of Compliance
O General Plan Amendment O Underground Waiver O Other ________________

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APPLICANT REQUIRED INFORMATION

SITE ADDRESS:____________________________________________PROPERTY SIZE:
PARCEL NUMBER: ________________________________________________ZONING:

OWNER OF PROPERTY:
    MAILING ADDRESS:
    CITY/STATE/ZIP:
   PHONE NUMBER:___________________________________FAX

APPLICANT: (Other than Property Owner)
    MAILING ADDRESS:
    CITY/STATE/ZIP:
    PHONE NUMBER:___________________________________FAX

ARCHITECT/DESIGNER/ENGINEER:
    MAILING ADDRESS:
    CITY/STATE/ZIP:
    PHONE NUMBER:___________________________________FAX

Please indicate with an asterisk (*) persons to whom correspondence should be sent.

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BRIEF DESCRIPTION OF PROPOSED PROJECT (attach separate sheet if needed):

I, the undersigned owner (or authorized agent) of the property herein described, hereby make application for approval of the plans submitted and made a part of this application in accordance with the provisions of the Town Ordinances, and I hereby certify that the information given is true and correct to the best of my knowledge and belief.

I understand that the requested approval is for my benefit (or that of my principal). Therefore, if the Town grants the approval, with or without conditions, and that action is challenged by a third party, I will be responsible for defending against this challenge. I therefore agree to accept this responsibility for defense at the request of the Town and also agree to defend, indemnify and hold the Town harmless from any costs, claims or liabilities arising from the approval, including, without limitation, any award of attorneys fees that might result from the third party challenge.

Signature:____________________________________________________ Date:
                (If other than owner, must have letter from owner)

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  NOTICE TO APPLICANTS

Pursuant to California Government Code Section 65945, applicants may request to receive notice from the Town of any general (non-parcel-specific) proposals to adopt or amend the General Plan, Zoning Ordinance, Specific Plans, or an ordinance affecting building or grading permits.

If you wish to receive such notice, then you may make a written request to be included on the mailing list for a periodic notice listing any such pending proposals, and must specify which types of proposals you wish to receive notice upon. The request must also specify the length of time you wish to receive such notice, and provide a supply of stamped, self-addressed envelopes. Applicants shall be responsible for maintaining the supply of such envelopes to the Town for the duration of the time period requested for receiving such notices.

The notice will also provide the status of the proposal and the date of any public hearings thereon which have been set. The Town will determine whether a proposal is reasonably related to your pending application, and send the notice on that basis.

Such notice shall be updated at least every six weeks unless there is no change to the contents of the notice that would reasonably affect your application.

Requests should be mailed to:

Town of Tiburon, Planning Department, 1505 Tiburon Boulevard, Tiburon, CA 94920

***READ ONLY. PLEASE APPLY TO TOWN OF TIBURON FOR OFFICIAL APPLICATION.***