CERTIFICATE OF LAND USE COMPLIANCE

Fee: Commercial $50.00 Residential: $25.00 Checks or Money Order Payable to The City of Atlantic City

Applicant’s Name:_____________________________________Phone:______________ Applicant’s Address:_______________________________________________________ E-mail Address___________________________________________________________ Owner’s Name:____________________________________Phone:_________________ Owner’s Address:_________________________________________________________ Owner’s Signed Consent__________________________________Date:_____________ Name and Address of Professional Consultant(s):________________________________ ________________________________________________________________________ Street Address of Subject Property:___________________________________________ Zoning District:______________ Block(s)________________ Lot(s)_______________ Present Use (include total number of units, describe fully): ______________________________ ________________________________________________________________________________________________________________________________________________ This Application is for (fully describe proposed use and/or signage, including total number of units): ________________________________________________________________________________________________________________________________________________________________________________________________________________________ Notice:1) THIS CERTIFICATION MAY NOT BE THE ONLY APPROVAL REQUIRED NOR DOES IT SUBSTITUTE FOR A CERTIFICATE OF NON-CONFORMITY, BUILDING PERMIT, PERMITS REQUIRED IN FLOOD HAZARD AREAS, MERCANTILE LICENSE OR OTHER STATE AND LOCAL PERMITS. 2) THE OWNER, BY HIS “SIGNED CONSENT” ABOVE, ALSO AUTHORIZES THE RELEASE OF THE PROPERTY RECORD CARDS AND ANY OTHER DOCUMENTS TO THE APPLICANT. _________________________ FOR OFFICE USE ONLY _________________________ Approved______________ Denied_______________ Conditions of Approval:____________________________________________________ ________________________________________________________________________ ________________________________________________________________________________________________________________________________________________ Application Number:___________ Fee Received:____________ Date Filed:_____________ Date Issued:______________ Authorization:____________________________________________________________

Keith B. Mills, P.P., Planning Director/Land Use Administrator ________________________________________________________________________ Distribution: Construction Division _____ City Engineer _____ Code Enforcement _____ Fire Department _____ Mercantile Office _____ Tax Assessor _____ CDBG Program _____ Health Department _____ Police Department _____ Other _____ REV: 4/29/14