JACKSON COUNTY, MISSOURI PLANNED DEVELOPMENT ZONING APPLICATION

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JACKSON COUNTY, MISSOURI PLANNED DEVELOPMENT ZONING APPLICATION APPLICANT INFORMATION: 1. Application must be filed with the Jackson County Planning and Development Division, 303 W. Walnut, Independence, Missouri 64050 by the date on the Plan Commission Calendar. 2. Application must be typed or printed in a legible manner. 3. All applicable sections must be completed. If you need more space to provide information, please use separate 8 1/2"x11" paper, reference the application number and attach it to the application. Incomplete applications will not be accepted and will be returned to the applicant. 4. Attach application for subdivision approval, consistent with the requirements of UDC Section 24003.10, as may be required. 5. Provide Site Development Plan and supporting documentation as provided in UDC Section 24003.18 paragraph e (See Item 14). 6. A signed statement by applicant that applicant understands and agrees that rezoning granted under this section may be revoked should actual use of the property deviate materially if planned development is granted. 7. The filing fee (non-refundable) must accompany application. (Check payable to Manager of Finance) $350.00 - Change of Zoning to Residential / Planned Development $500.00 - Change of Zoning to Commercial or Industrial / Planned Development TO BE COMPLETED BY OFFICE PERSONNEL ONLY: Rezoning Case Number RP- Date Filed Date of hearing Date advertised Date property owners notified Date signs posted Hearings: Heard by Date Decision Heard by Date Decision Heard by Date Decision BEGIN APPLICATION HERE: 1. Data on Applicant(s) and Owner(s) a. Applicant(s) Name: Address: Phone b. Owner(s) Name: Address: Revised 11/1/07

Phone: c. Agent(s) Name: Address: Phone: d. Applicant's interest in Property: 2. General Location (Road Name) 3. Present Zoning Requested Zoning 4. AREA (sq. ft. / acres) 5. Legal Description of Property: (Write Below or Attached ) 6. Present Use of Property: 7. Proposed Use of Property: 8. Proposed Time Schedule for Development: 9. What effect will your proposed development have on the surrounding properties? 10. Is any portion of the property within the established flood plain as shown on the FEMA Flood 2

Boundary Map? If so, will any improvements be made to the property which will increase or decrease the elevation? 11. Describe the source/method which provides the following services, and what effect the development will have on same: a. Water b. Sewage disposal c. Electricity d. Fire and Police protection 12. Describe existing road width and condition: 13. What effect will proposed development have on existing road and traffic conditions? 14. Are any state, federal, or other public agencies approvals or permits required for the proposed development? If so, describe giving dates of application and status (include permit numbers and copies of same, if issued): 15. PLANNED ZONING APPLICATION SHALL INCLUDE SITE DEVELOPMENT PLAN: An accurate, legible site plan, drawn to scale and containing the following information: a. the legal description of subject property; b. the limits, dimensions, and square footage/acreage of property and the development of property adjacent to the area within three hundred (300) feet; c. the topography in intervals no greater than ten (10) feet; d. general location and width of all proposed streets and public rights-of-way, such as pedestrian ways and easements. e. entrances and exits from streets or indication of the criteria for entrance and exit 3

placement; f. proposed building layout illustrating the front, side and rear building setback lines. g. proposed use of buildings, or a description of the proposed uses by type, character, and intensity; h. location and amount of parking or loading, or indication of the proposed parking and loading ratio and the location criteria; i. location, type, and size of signs, or indication of the criteria for location, type and size of signs. 4

Verification: I (We) hereby certify that all of the foregoing statements contained in any papers and/or plans submitted herewith are true to the best of my (our) knowledge and belief. Signature Date Property Owner(s) Applicant(s): Contract Purchaser(s): STATE OF COUNTY OF On this day of, in the year of, before me the undersigned notary public, personally appeared known to me to be the person(s) whose names(s) is/are subscribed to the within instrument and acknowledged that he/she/they executed the same for the purposes therein contained. In witness whereof, I hereunto set my hand and official seal. Notary Public Commission Expires 5