TOWNSHIP OF BRICK LAND DEVELOPMENT APPLICATION

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TOWNSHIP OF BRICK LAND DEVELOPMENT APPLICATION Application NO. Planning Board Zoning Board Date of Submission - - Mo. Day Yr. Application Fee $ Escrow Fee $ A. Applicant Street City & State Zip Code Telephone # Listed ( ) Unlisted ( ) (If not owner, set forth ownership interest, contact purchaser, etc., & attach copy of document following same). Owner Street City & State Zip Code Telephone # Listed ( ) Unlisted ( ) B. TYPE OF APPLICATION: New Amended 1. Minor Subdivision 4. Site Plan-Prel. 2. Major Sub.-Prel. 5. Site Plan-Final 3. Major Sub.-Final 6. Conditional Use Date of Prel. App. (Must be accompanied by Site Plan) 7. Minor Site Plan 8. Cluster Zone 12. C.40:55D-70D 9. C.40:55D-70A 13. C.40:55D-34 10. C.40:55D-70B 14. C.40:55D-35 11. C.55D-70C C. PREVIOUS APPEALS OR ACTIVITY No Yes If yes, date - - Type Variance Mo. Day Year Approved Disapproved

D. Location: Street Zone District: Tax Map # Block (s) Lot (s) # Type of Road: Cul-de-sac Secondary Minor Major Collector Arterial Number of proposed streets w/names: Residential Business Other R-5 B-1 H-S R-7.5 B-2 R-10 B-3 R-15 B-4 R-20 R-R-1 R-R-2 R-R-3 R-M Office Professional/Light Industrial O-P O-P-T M-1 E. DESCRIPTION OF PROPOSED USED: 1. Present Use 2. Proposed Use 3. No. of Lots/Units 4. Brief Description of Application 5. Lot Size: Lot Area Lot Area Frontage/Width Depth Sq. Feet Acres Proposed: Required:

5A. Does Applicant/Owner Own Adjoining Property? Yes No If yes please describe: 6. Primary Building Setback Requirements: Front Sides Rear Proposed Required 7. Accessory Building Setback Requirements: Side Rear Proposed Required 8. Height: Proposed Max. Allowed 9. Percent of Lot Coverage Building Proposed Allowed 10. With Percent Impervious Coverage Proposed Allowed 11. Gross Floor Area Proposed Sq. Ft. Min. Required Sq. Ft. 12. Number of Parking Spaces: Off Street Loading Proposed Min. Req. 13. Basis for determining parking requirements: Employees Units Seats Beds Courts Rooms Stalls Other Show parking caluclations:

F. UTILITIES 1 Water: Will the applicant require new water supply in street? Yes No Is Municipal water supply available? Yes Is water to be supplied from a well? Yes No No Has application been made to the B.T.M.U.A.? Yes No Has application been approved? Denied Date Comments 2. Sewerage: Will this application require new sewage lines in streets? Yes No Will the application require expansion of existing lines? Yes No Will this application require a septic system? Yes No 3. Gas: Natural Gas Existing Above Ground Propane Proposed Below Ground 4. Electric: Existing Above Ground Proposed Below Ground G. Has application been made to the Ocean County Planning Board? Approved Denied Date H. Deed Restriction or Covenants? Yes No (If yes, attach copy) I. Certificate of Taxes/assessments paid to date attached? (Said certificate to be submitted with application for acceptance) J. Has application been made to the Tax Assessor for Block & Lot assignments: Yes No Proposed building, structure or use thereof is contrary to Brick Zoning Ordinance in the following particulars (state articles & sections) K. ARGUMENTS FOR VARIANCE: (To be completed by applicant) Undue hardship consideration (C1 or C2): Negative Criteria: (To be completed for D variance & Conditional Use Variance applications)

Special Reasons: (To be completed for D variance only) L. Has there been a market value offer to sell or purchase all or part of adjoining property if applying for C variance, i.e. lacking square footage, width or depth? Yes No M. List of maps, reports and other material accompanying application: (Appropriate checklist must accompany all site plan and subdivision applications) NO. DESCRIPTION OF ITEM MO. DATE YR. 1. 2. 3. 4. 5. N. LIST OF INDIVIDUALS WHO PREPARED PLANS: 1. Engineer/ Surveyor 2. Architect 3. Site Planner 4. Attorney

O. AUTHORIZATION OF SIGNATURE (If applicant is a corporation) This will certify that Title of (Corporation & ) who subscribed to the above application for development in the Township of Brick has been authorized by this Corporation to do so. Attest Secretary (Corporate Seal) Corporate President N.J.S.A. 40:55D-48.1 et seq. Requires all corporations or partnerships applying to a Planning Board or Board of Adjustment for permission to subdivide a parcel of land into six (6) or more lots or applying for a variance to construct a multiple dwelling of twenty-five (25) or more family units or seeking approval of a site to be used for commercial purposes to list: a) If a corporation names and addresses of all stockholders owning at least 10% of its stock of any class; b) If a partnership names and addresses of the individual partners having at least 10% interest in the partnership. P. AFFIVDAVIT OF APPLICANT: STATE OF NEW JERSEY COUNTY OF OCEAN of full age being duly sworn according to law, on oath deposed and says, that all of the above statements and the statements contained in the papers submitted herewith are true. Sworn and Subscribed to: before me this day: of, 20 : Applicant to sign here

Q. AFFIDAVIT OF OWNERSHIP: STATE OF NEW JERSEY COUNTY OF OCEAN of full age being duly sworn according to law on oath deposed and says, that all the deponents reside at in the of and State of that is the owner in fee of all that certain lot, piece of land situated, lying and being in the municipality aforesaid, and known and designated as Block (s) Lot (s) Street Sworn and Subscribed to before me this day of, 20 : R. AUTHORIZATION BY OWNER: (Owner to Sign Here) (If anyone other than above owner is making this application, the following authorization must be executed) To the approving Board of the Township of Brick: is hereby authorized to make the within application. Dated: Owners Signature S. ADDRESS ALL CORRESPONDENCE CONCERING THIS APPLICATION TO: ( ) Applicant ( ) Owner ( ) Attorney and Firm T. WITNESS FOR APPLICANT Identifying letter to proceed name of witness: S Self/Relative N Neighbor O Other T Twp. Employee E Expert 1. 2. 3. 4. 5.