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5400 West Civic Center Drive ~ Suite 1 Highland, UT 84003 Phone 772-45155 Fax 756-6903 Community Development Department CONDI ITIONAL USE PERMIT APPLICATION STAFF USE ONLY Application Date: / / Application Number: Fee Owed: $485.00 Received by: Receipt #: Cash/Card/Check (Check #: ) Planning Commission Meeting Date: City Council Meeting Date: Application: Approved/Denied Staff Comments: PROJECT INFORMATION Name: Address: Acreage/Property Size: APPLICANT INFORMATION Name: Mailing Address: Phone #: Fax #: Email Address: Owner Information Owner Name: Owner Address: Owner Phone #: Owner Email Address: _ Owner s Signature: 1

PROPERTY OWNERS AFFIDAVIT I (we), being first duly sworn, depose and say thatt I (we) am (are) the current owner of the property involved in this application; that I (we) have read the application and attached plans and other exhibits and are familiar with its contents; and that said contents are in all respects true and correctt based upon personal knowledge. Owner s Signature Owner s Signature (co-owner, if any) State of County of Subscribed and sworn to (affirmed) before me this day of, 20. Notary Public AGENT AUTHORIZATION AFFIDAVIT I (we),, owner( (s) of the real property located at, in Highland City, Utah, do hereby appoint, as my (our) agent to represent me (us) with regard to this application affecting the able described real property. Owner s Signature Owner s Signature (co-owner, if any) State of County of Subscribed and sworn to (affirmed) before me this day of, 20. Notary Public 2

5400 West Civic Center Drive ~ Suite 1 Highland, UT 84003 Phone 772-4515 Fax 756-6903 Community Development Department CONDITIONAL USE PERMIT CHECKLIST *The following items are required for proceessing. An application will not be accepted without these items.* TO BE COMPLETED DELIVERABLES BY STAFF YES NO Completed and Signed Planning Application. Applicant's and owner's original signatures on Planning Application. Review Fee: $485.00 (new application) or $100.00 (amendment). Legible vicinity map indicating the exact location of the property on a separate 8 1/2"x11" sheet (1 copy). Legal description of property on a separate 8 1/2"x11" sheet (1 copy). Current Title Report (1 copy). Property ownership map and list within 500 feet and affidavit of notification (see page 5). Addressed, stamped envelopes with no return address for all property owners within 500 feet of the property. Site Plan - 24"x36" (3 copies) Copies must be drawn to scale. All 24"x36" plans shall be grouped together as a set, not per type of plan or drawing. Building Elevations and/or Floor Plan (if applicable) - 24"x36" (3 copies) Copies must be drawn to scale. Lighting Plan/Photometric and cut sheets (if applicable) - 24"x36" (3 copies). Landscape/Hardscape Plan - 24"x36" (3 copies) and landscape maintenance schedule. Reduced copies of all required full sized plans 11"x17" (5 copies). All plans on disc as PDF labeled and dated (1 copy). Neighborhood Notification Meeting Packet. *The applicant should be aware that there may be requests to provide additional materials for staff review, Planning Commission and/or City Council meetings.* Signature: Date: Printed Name: Phone Number: *This application requires a Neighborhood Notification Meeting as well as a Public Hearing by the Planning Commission.* 3

1. That such use will not under the circumstances of the particular case, be detrimental to the health, safety, or general welfare of persons residing or working in the the vicinity, or injurious to property or improvements in the vicinity. 2. That the proposed use will comply with regulations and conditions specified in the Highland City Development Code for such use. 3. Upon the recommending of any conditional use permit, the Planning Commission shall itemize, describe, and justify the conditions imposed on the use. In addition to the items listed above, please address the following topics in a typed narrative on a separate sheet of paper: 1. Detailed description of the proposed use. 1. Consistency with the General Plan and compliance with the Development Code and other city codes and regulations. 2. General compatibility of proposed use with adjacent property. 3. Site and building design with exterior lighting with reference to adjacent properties. 4. Address ingress and egress to the property and proximity to driveways and street intersections in the vicinity of the subject property. 5. 6. 7. 8. 9. 10. 11. 12. 13. CONDITIONAL USE PERMIT PROJECT NARRATIVE *The following must be included/addressed. An application will not be accepted without a project narrative.* In recommending any conditional use, the Planning Commission shall impose such requirements and conditions as it deems necessary for the protections of adjacent properties and the public welfare. A conditional use permit shall not be granted unless the evidence presented by the applicant is such as to show all of the following: The recommendation of the Planning Commission shall be forwarded to the City Council. The City Council may then grant, modify, or reject the permit. The project narrative provides staff, Planning Commission, and City Council with the information necessary to evaluate the requested conditional use permit. Internal vehicular circulation including emergency and delivery vehicles. Pedestrian and alternative vehicle considerations for the proposed use. Volume and character of traffic as well as off-street parking and loading. Impact of public services, including utilities, schools, and recreation. Screening and buffering of uses. Proposed outdoor activities or storage. Hours of operation and number of employees. Noise, smoke, odor, dust, vibration, or illumination created by the proposed use. Additional information as needed. *This application requires a Neighborhood Notification Meeting as well as a Public Hearing by the Planning Commission.* If you have any questions regarding items on this checklist or the process, please contact the Community Development Department at 801-772-4515. 4

5400 West Civic Center Drive ~ Suite 1 Highland, UT 84003 Phone 772-4515 Fax 756-6903 Community Development Department INSTRUCTIONS FOR PROPERTY OWNERSHIP NOTIFICTION MAP, LIST, AND ENVELOPES 1. Obtain names and addresses of property owners within 500 feet of the property by using the Utah County Property Notification Map feature. Go to the following web address: https://maps.utahcounty.gov/propertynotification/propertynotification.htm If this link does not work, try searching for Utah County Property Notification Map as the county will often change their web address. 2. Enter the street address of the property and the city. Click the Find Address button. 3. Enter a buffer distance of 500 feet and click anywhere on the map. This will create a red radius line around the property indicating properties within 500 feet. 4. Print the map that is generated showing the 500 foot radius. To print the screen, press the Print Screen key on the keyboard. It may be labeled [PrtScn]. Open a program such as Microsoft Word. Right click in the document and choose Paste to paste the copied map into the document (see example at the bottom of the page). Submit the printed map to staff when submitting the application. 5. Next, click the Download CSV File button (you may need to press the Ctrl button while clicking the CSV button). This will generate a list of surrounding property owners in an Excel spreadsheet. If this step does not work, a pop-up blocker may need to be disabled. 6. Print and submit the generated list of surrounding property owners to staff when submitting the application. 7. Prepare and submit to staff a set of addressed, stamped envelopes with no return address for all property owners from the generated list. 6

AFFIDAVIT OF NOTIFICATION Date: Project Name: Address/ /Legal Description of Property: I (we), certify that I (we)am the authorized applicant to Highland City for the above application, and do hereby affirm the attached listing of names and addresses accurately reflects the ownership of property within 500 feet of the above property, according to the Utah County Assessor records on / /. Month Day Year Applicant/Representative Signature: State of County of Subscribed and sworn to (affirmed) before me this day of, 20. Notary Public 6