Proposed Use(s) Company. Contact. Address. Telephone. Fax. *

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City of Southlake ZONING APPLICATION Department of Planning & Development Services, 1400 Main Street, Suite 310, Southlake, TX 76092 Phone: (817) 748-8069 : (817) 748-8077 Website: www.cityofsouthlake.com Subdivision Name Lot(s) Block(s) Survey Name(s) Abstract No.(s) Tract(s) Address/Location Current Zoning If more than one zoning district, list all here Requested Zoning Acres or Sq. Ft. SPIN Meeting Existing Use(s) Reason for Zoning Change Company Applicant Proposed Use(s) Company Owner (attach additional sheets if necessary) Contact Contact Address Address Telephone Telephone Main Contact for Project Phone *Email should only be provided if you consent to your email address becoming a part of public record. I hereby certify that this application is in conformance with the requirements of the Zoning Ordinance No. 480, as amended and other ordinances, maps, and codes of the City of Southlake that pertain to this submittal. I understand that it is my responsibility to have the Applicant, Owner or other authorized agent present at the Planning and Zoning Commission and City Council meetings. Should an authorized person not be at the meeting to represent the application, I hereby request that consideration of the item be continued to a future date to allow an authorized person the opportunity to appear and present testimony. However I do understand that the City is not obligated to continue this request. I further understand that this request will be placed on the appropriate Planning & Zoning Commission and City Council agendas in accordance with the limitations of Resolution No. 97-22 and where a plat is submitted concurrently with zoning request, concept plan, site plan, or development plan, and approval of the plat is contingent upon receiving the requested zoning and/or plan approval, I hereby request that these items be processed concurrently on the same agenda. Signature of Applicant, Owner, or Authorized Agent Printed Name ITEMS REQUIRED WITH SUBMITTAL The items listed in the Submittal Guidelines & Requirements must be received no later than 5:00 PM on the submittal deadline (refer to schedule) and are required to qualify as an adequate submittal. Upon determination of its inadequacy, the submittal will not be accepted and will be promptly returned to the applicant. For Pre-Submittals please submit 7 copies of all items, unless otherwise noted. For Formal Submittals, please submit 27 copies of all items, unless otherwise noted. Blueprints should be 24 by 36 and folded 12 by 9. One 11" by 17" reduction and a digital pdf format file of each plan is required with all submittals. Revised December 2016

CITY OF SOUTHLAKE GUIDELINES FOR POSTING PUBLIC HEARING SIGNS (ZONING CHANGES, CONCEPT PLANS, SITE PLANS, SPECIFIC USE PERMITS) APPLICANT, OWNER OR AUTHORIZED AGENT MUST READ AND SIGN Below are the procedural guidelines which must be closely followed when posting the signs to ensure proper consideration of the zoning issue. I. The Applicant, Owner or Authorized Agent assumes responsibility for the placement of the public hearing signs on the same property listed in the application for the zoning change. These zoning signs are required by the Comprehensive Zoning Ordinance as part of the public notice process. Failure to place signs will result in mandatory tabling of the zoning change request. II. III. IV. The signs must be in place on the subject property at least fifteen (15) days prior to the public hearing to be held before the City Council. Signs are made available at the time of formal submittal. One (1) sign must be placed on each property line with street frontage. If the street frontage is greater than 1,000 feet, one sign must be placed for every one thousand (1,000) feet of street frontage. One sign must also be placed at every proposed tie-in or continuation of an existing public street. Signs must be placed in the most prominently visible locations as possible, but should not be placed where they might serve as an obstruction of view for motorists. Ideally, the placement of signs ten to fifteen (10'-15') feet from the edge of the roadway, clear of any excessive undergrowth, would serve this requirement. The city reserves the right to request the signs be relocated to improve visibility. V. The signs must remain in place on the subject property throughout the time action is being taken on the case. The Applicant, Owner or Authorized Agent should notify the city if a sign appears to have been removed from the property and must obtain a replacement sign from the city. It is the responsibility of the Applicant to remove the signs from the property after final action has been taken on the zoning issue. I have read the above requirements concerning the posting of zoning change signs and understand my responsibilities as the Applicant, Owner or Authorized Agent. Applicant, Owner or Authorized Agent Witness

PROPERTY OWNER ACKNOWLEDGEMENTS Notarized signature of all owners is mandatory. Use additional sheets if necessary. Property Ownership Acknowledgement: As owner of the property described in this application, I understand that my property is being considered for rezoning. In addition, I have read and understand the attached "Guidelines for Posting Public Hearing Signs" and understand it is my responsibility as the property owner to place the required signs in compliance with these guidelines. I hereby release the City of Southlake and its employees from liability for any damages which may be incurred to my property in erecting, maintaining, or removal of said signs. I hereby understand that it is necessary for me or my agent to be present at the Planning and Zoning Commission and City Council public meetings to represent this request. Signature of Owner Owner's Name (Typed or Printed) Notary Acknowledgement: Before me, the undersigned authority, on this day personally appeared known to me to be the person whose name is subscribed to the above and foregoing instrument, and knowledge to me that he/she executed the same for the purposes and consideration expressed and in the capacity therein stated. Given under my hand and seal of office on this the day of, 20. Notary Public In and For Texas My commission expires the day of, 20. Agent Authorization (if applicable) Agent Authorization: I, that I have given my permission to, owner of the aforementioned property do hereby certify to act as my agent for this rezoning request. Signature of Owner Owner's Name (Typed or Printed) Notary Acknowledgement: Before me, the undersigned authority, on this day personally appeared known to me to be the person whose name is subscribed to the above and foregoing instrument, and knowledge to me that he/she executed the same for the purposes and consideration expressed and in the capacity therein stated. Given under my hand and seal of office on this the day of, 20. Notary Public In and For Texas My commission expires the day of, 20.

Traffic Impact Analysis Title of Plan Case Number THRESHOLD WORKSHEET Driveway Ordinance No. 634 requires that a Traffic Impact Analysis (TIA) be submitted with development applications (zoning, concept plan, site plan, etc.) if the proposed development exceeds one or more of the three threshold criteria listed below. No development applications will be accepted unless accompanied by a TIA. For those projects that do not exceed any of the three criteria, a TIA Threshold Worksheet must be submitted and approved by the City Engineer in lieu of the required TIA prior to submittal of the development application. Please describe in detail your evaluation of each criteria listed below. Additional sheets may be attached if necessary. Criteria #1:The development exceeds parking 100 spaces average per driveway. Criteria #2:Any driveway in the development is projected to serve 1000 or more vehicles per day.* Criteria #3:Any driveway in the development is projected to serve 100 ingress vehicles or more in the design hour.* * Unless approved otherwise, trip generation rates should be based on the most recent edition of the Institute of Transportation Engineers (ITE) Trip Generation Manual. I hereby certify that this project does not exceed any of the three threshold criteria shown above and therefore the development would not warrant a TIA in accordance with Section 3.4 of the Driveway Ordinance No. 634 of the City of Southlake. Name Registration No. Firm Phone For City Use Only: The requirement for a Traffic Impact Analysis with this submittal is hereby waived: Name: Title: :

City of Southlake Zoning Change Submittal Guidelines & Requirements Department of Planning & Development Services, 1400 Main Street, Suite 310, Southlake, TX 76092 Phone: (817) 748-8069 : (817) 748-8077 Email: planning@ci.southlake.tx.us Website: www.cityofsouthlake.com Basic Submittal Requirements Guidelines for Posting Public Hearing Signs signed by Applicant, Owner, or Authorized Agent. Property Owner Acknowledgements signed and notarized by all owners. Notarized signature of all owners is mandatory. Traffic Impact Analysis (5 copies) or Threshold Worksheet Release Form signed by the City Engineer. Preliminary Drainage Study prepared, sealed, signed, and dated by a professional engineer. This requirement may be waived only by the City Engineer prior to submittal of this application. (Waiver approval signature: : ) Site Plan/Development Plan Application required by Section 40 of the Zoning Ordinance for all "NR-PUD", "R-PUD", "S-P-1", "TZD", "RCS", "ECZ" and all zoning requests for properties within Corridor Overlay Zone (see Zoning Ordinance Section 43.9). Concept Plan Application required by Section 41 of the Zoning Ordinance for all "SF-1A", "SF-1B", "SF-2", "SF-30", "SF-20A", "SF-20B", "S-P-2", "MF-1", "MH", "CS", "B-1", "B-2", "HC" and all zoning requests for properties within the Corridor Overlay Zone (see Zoning Ordinance Section 43.9). Unless otherwise required, a Site Plan may be substituted for a Concept Plan. Clear and legible metes and bounds description of the property typed in 8.5" by 11" or 14" format for unplatted property (1 copy). Current survey of property, showing property lines and location of existing improvements, in 11" by 17" format (1 copy). Copies of written documents, including but not limited to a written narrative describing the use, operation, etc. and demonstrating compliance with the Land Use Plan (1 copy). Comprehensive Plan Amendment Application if the proposed zoning is not consistent with the Land Use Plan. Payment in the amount of $ (made payable to the City of Southlake). Application signed by Applicant, Owner, or Authorized Agent. The above items must be received no later than 5:00 PM on the submittal deadline (refer to schedule) and are required to qualify as an adequate submittal. Upon determination of its inadequacy, the submittal will not be accepted and will be promptly returned to the applicant. For Pre-Submittals and Re-Submittals, please submit 12 copies of all items, unless otherwise noted. For Formal Submittals, please submit 27 copies of all items, unless otherwise noted. Blueprints should be 24" by 36" and folded 12" by 9". One 11" by 17" reduction of each plan is required with all submittals.