CHIPPEWA TOWNSHIP

VARIANCE REQUEST TO THE BOARD OF ZONING APPEALS

(BZA)

Please fill out this application. All information and application fees in this application must be submitted by the filing deadline (a copy is attached) or the application will not be processed. Application must be made by the owner of the property. Application before the BZA must pass the motion by three yes votes for granting. Provide this completed application, along with other material submitted to the Chippewa Township Zoning Department for processing. All meetings for this request will be heard at the Township Hall located at 14228 Galehouse Road, Doylestown, Ohio 44230. The owner and/or agent must be present at the hearing for this matter to be heard by the BZA.

Application fee ___________ Date of hearing _________________ Time of hearing __________ P.M.

Type of variance request _________ use variance __________ area variance ____________ other

Relief from Article _______ Section ______ of the zoning resolution. Variance No. _______

Brief Description ______________________________________________________________

This Section to be completed by Township Zoning department.

______________________________________________________________________________________

I. General Information (please type or print)

1) Applicant/Owner’s Name ___________________________________________________

Address of Property ____________________________________________________

Mailing Address _______________________________________________________

_______________________________________________________

Phone ____________________________ Fax _________________________

2) Agent for Owner Name ____________________________________________________

Mailing Address _______________________________________________________

________________________________________________________

Phone ____________________________ Fax __________________________

3) Location of the Property Section _____________________ Quarter __________________

4) Current Zoning Classification _________________________________________________

5) Lot Frontage _______________ Lot Depth __________________ Acreage _____________

6) Legal Description __________Copy of deed (attached) ___________Other

CTZON200602VARIANCEREQTFORM

7) Authorization for __________________________________ (name) to act as my agent at the hearing.

A notarized written authorization must be attached from the owner granted an agent permission
to speak and present this request on the behalf of the owner.

Authorization attached __________ yes _________ no

8) Building information

Number of existing accessory buildings_______ Dwellings_______ Proposed buildings ______

Proposed accessory building ____________Width ___________Length __________Height

Proposed dwelling ____________Width ___________Length __________Height

Proposed sign ____________Width ___________Length __________Height

See attached plot plan for location of buildings.

II. Description of Variance Request

1. Describe your proposed request ______________________________________________

____________________________________________________________________________________

III. Approval criteria for Variances

            For reasons fully set forth in the written findings, the literal application provision would
            result in unnecessary and undue hardship or practical difficulties for the applicant,
           as distinguished from mere inconvenience.

1. Hardship or practical difficulties ______________________________________________

___________________________________________________________________________________

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IV. Required Attachments

1. Proof of Ownership – A copy of the deed, option to buy agreement or lease purchase
agreement.

2. Detailed Site Plan (9 copies full size, to scale 8 ½” x 11” or larger, if needed). A detailed
site plan must include the following.

a. Size of lot and dimensions drawn to an appropriate engineer’s scale.

b. Location and size of all buildings, indicating setbacks of buildings (existing and proposed).

c. Size of parking areas showing parking spaces and setbacks, if applicable.

d. Indicate existing and proposed landscape features, if applicable.

                  e. Parking area showing number of spaces, size bumper guards, curbs, curb cuts,
                     traffic circulation patterns, sidewalks, fences, shrubs, ground cover, hedges and lighting,
                    if applicable.

f. Type of hard surface, if applicable.

g. Drainage features, if applicable.

3. Tax Map - Copy from Township Office.

4. Photographs of the Property – Submit 3”x5” photographs showing the property from the
north, south, east and west direction.

5. Provide this application, site plan, notarized authorization, if required, deed, plat, etc.

         6. Provide a list of the owners of all property contiguous to and directly across the street
                from the subject property. A list of such contiguous property owners and their addresses of
               such owners appearing on the Wayne County Auditor’s current tax list. To obtain this
               information from the Wayne County Auditor’s website, the address is
              www.waynecountyauditor.org .

PLEASE SIGN BELOW:

I hereby certify that all statements made in this application are true and complete and that
I have a legal right or do possess a written power of attorney on above premises. A Variance
can only be granted to the Owner of the property.

________________________________________________ __________________

SIGNATURE DATE

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APPLICANT/OWNER’S NAME ______________________________ VARIANCE NO. _______

LOCATION OF PROPERTY _____________________________________________________

PROVIDE A LIST OF THE OWNERS OF ALL PROPERTY CONTIGUOUS TO AND DIRECTLY
ACROSS THE STREET FROM THE SUBJECT PROPERTY. A LIST OF SUCH CONTIGUOUS
PROPERTY OWNERS AND THEIR ADDRESSES OF SUCH OWNERS APPEARING ON THE
WAYNE COUNTY AUDITOR ’S CURRENT TAX LIST.

CONTIGUOUS CONTIGUOUS CONTIGUOUS CONTIGUOUS

PROPERTY’S PROPERTY’S PROPERTY OWNERS PROPERTY’S
OWNERS ADDRESS NAME MAILING ADDRESS

PARCEL NO.

__________________________________________________________________________________________

________________________________ _________________

APPLICANT’S SIGNATURE DATE

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