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Community Development 7525 NW 88 th Avenue Tamarac, FL 33321 Telephone (954) 597-3530 Fax (954) 597-3540 FOR STAFF USE ONLY: CASE #: Master File #: HTE Project #: Date Received: Received by: Fee(s) Collected: B - CASE DEVELOPMENT APPLICATION VARIANCE Project Name: Project Address (if applicable): Project Location: Parcel Size: Project Description: acres/sq. ft. Folio No. (Identify existing and proposed land use classification and proposed density, if applicable.) Applicant/Agent/Contact: Phone: Address: Fax: E-Mail Address: Property Owner s Name: Phone: Address:

VARIANCE APPLICATION CHECKLIST The following checklist is designed to assist the applicant in preparing the required materials for review. The application will not be accepted if all required items are not present at the time of submittal. The following items are required as part of a complete application for a Variance: 1. A completed City of Tamarac Variance Application. 2. Justification Letter. Plan shall encompass all requirements from Chapter 10-5.4 (Q) of the City s Land Development Code entitled Variance including specifically the required Review Standards listed on 10-5.4 (Q) (4) (a). 3. Application Summary Sheet. 4. Designation of Agent for Quasi-Judicial Proceedings form. This form must be completed by the property owner. The form names that person who will represent the said application. 5. Proof of property ownership. (i.e. deed, property appraisers, or contract to purchase) 6. Local Publication Agency Fee Affidavit all legal advertisements will be processed by the City of Tamarac. Applicants will be billed at a later time for the cost of the legal advertisement in local print publication. 7. Public Hearing Signs must be posted on the property (at each public right-of-way) within three (3) days of the submittal of the official development application. 8. Public Hearing Sign Affidavit must be submitted to the Community Development Department seven (7) days prior to the scheduled public hearing date. 9. Completion of the Public Notification process shall be in conformance with Table 10-5.2 General Notice Requirements in Chapter 10-5.3 (F). 10. Public Notification Affidavit. (Due seven (7) days prior to the scheduled public hearing date) 11. One (1) copy of a plat/survey dated within the last twelve (12) months. 12. Appropriate fees. Each Variance requested shall be subject to the Community Development Fee Schedule per Variance requested. **INCOMPLETE APPLICATIONS WILL NOT BE ACCEPTED**

APPLICATION SUMMARY SHEET NAME OF PROJECT LOCATION OF PROJECT COMMISSION DISTRICT # PROJECT IS BEING PROPOSED IN FOLIO PARCEL SIZE APPLICATION TYPE Amendments Large Scale Land Use Plan Map Amendment Small Scale Land Use Plan Map Amendment Comprehensive Plan Text Amendment Land Development Code Text Amendment Establishment of Use PROJECT DESCRIPTION Planned Development Plan/Agreement Planned Development Plan/Amendment Permits & Development Approvals Rezoning Special Exception Plat Approval Site Plan Approval (Major) Site Plan Approval (Minor) Site Plan Extension Vacation of Easement/Rights of Way Relief Procedures Administrative Adjustment Variance Administrative Appeal OTHER PROPOSED NUMBER OF UNITS OR SQ. FT. (for Major Site Plan Approval) PROPOSED HEIGHT (for Major Site Plan Approval) APPLICANT S NAME AND COMPANY APPLICANT S PHONE APPLICANT S EMAIL ADDRESS PROPOSED DATE OF PRE-APPLICATION NEIGHBORHOOD MEETING PROPOSED LOCATION OF PRE-APPLICATION NEIGHBORHOOD MEETING PROPOSED DATE OF DRC

DESIGNATION OF AGENT FOR QUASI-JUDICIAL PROCEEDINGS DATE: PROJECT NAME: IN THE MATTER OF: ANY PERSON APPEARING ON YOUR BEHALF, IN YOUR ABSENCE, MUST BE DESIGNATED AS YOUR AGENT ON THIS FORM OR SUCH PERSON WILL NOT BE ENTITLED TO SPEAK AT THE QUASI-JUDICIAL HEARING AND THE MATTER MAY BE DETERMINED WITHOUT THE BENEFIT OF THEIR TESTIMONY., WILL ATTEND THE QUASI-JUDICIAL (Print Name of Designated Agent) HEARINGS TO BE HELD IN MY ABSENCE. IN ADDITION, HAS MY (Print Name of Designated Agent) PERMISSION TO ACT AS MY AGENT IN ALL MATTERS RELATING TO ANY PROCEEDINGS RELATED TO, LOCATED AT. (Name of the Project) (Address of the Subject Property) THIS FORM MUST BE COMPLETED AND RETURNED PRIOR TO THE QUASI-JUDICIAL HEARING SIGNATURE OF OWNER: (Print Name of Property Owner) SIGNATURE OF DESIGNATED AGENT: (Print Name of Designated Agent) ADDRESS AND PHONE NO. OF DESIGNATED AGENT: Phone: Fax: STATE OF: COUNTY OF: The forgoing instrument was acknowledged before me this day of, 20, by, the owner of the property, who is personally known to me or has produced identification (type of identification) and who (did/did not) take an oath. My Commission Expires: Type or print name of Notary: Seal/Stamp

LOCAL PUBLICATION AGENCY FEE AFFIDAVIT Recovery of cost of public notification fees in local publication advertisements: There is hereby imposed a fee for all site specific projects which will be processed through the Quasi-Judicial hearing process therefore requiring additional public notification in local publication. The fee(s) associated with these publications will be determined at a later date and the applicant will be notified of the associated fee(s) by invoice from our Financial Services Department, when deemed necessary by the Director of Community Development. Such fee shall be equal in amount to the actual costs, as determined by the by the City s outside local publication agency. THIS FORM MUST BE COMPLETED AND RETURNED AT THE TIME OF SUBMITTAL. SIGNATURE OF DESIGNATED AGENT: (Print Name of Designated Agent) ADDRESS AND PHONE NO. OF DESIGNATED AGENT: Phone: Fax: STATE OF: COUNTY OF: The forgoing instrument was acknowledged before me this day of, 20, by, who is personally known to me or has produced identification (type of identification) and who (did/did not) take an oath. My Commission Expires: Type or print name of Notary: Seal/Stamp

STATE OF FLORIDA COUNTY OF BROWARD PUBLIC HEARING SIGN AFFIDAVIT I,, do swear and affirm: (Print Name) 1. That I have posted a Notice of Public Hearing on the Property on, 20, for a hearing to be held before the City of Tamarac City Commission/Planning Board (circle one) on, 20. 2. The Notice was placed at the location set forth below:. 3. The location where the Notice was placed was legible from the adjoining roadway.. Affiant Signature Sworn to and subscribed before me this day of, 20. Notary Public State of Florida Type or Print Name of Notary My Commission Expires: Seal/Stamp

PUBLIC POSTED NOTICE SIGN REQUIREMENTS (10-5.3(F)(3) LDC) EACH LETTER ON THE SIGN(S) SHALL BE AT LEAST FOUR INCHES (4 ) IN HEIGHT. THE SIGN(S) MUST BE ATTACHED TO A POST WHICH IS IMPLANTED IN THE GROUND. THE FREE-STANDING SIGN(S) SHALL BE THREE FEET BY THREE FEET (3 X 3 ) IN SIZE AND POSTED CONSPICUOUSLY AT LEAST TWO FEET (2 ) ABOVE GRADE ON EACH RIGHT-OF-WAY OF THE PROPERTY. THE SIGN(S) MUST BE POSTED AT LEAST FIFTEEN (15) DAYS BEFORE THE HEARING DATE, AND SHALL BE REMOVED WITHIN 14 DAYS AFTER THE FINAL CITY DECISION ON THE APPLICATION. THE LANGUAGE ON THE SIGN SHALL, AT A MINIMUM INCLUDE: LAND DEVELOPMENT ACTION IS BEING PROPOSED TO THE CITY OF TAMARAC FOR THIS PROPERTY. APPLICATION TYPE; DATE, TIME AND LOCATION OF THE MEETING BEING NOTICED; PLEASE CALL THE COMMUNITY DEVELOPMENT DEPARTMENT AT (954) 597-3530 FOR FURTHER INFORMATION.

STATE OF FLORIDA COUNTY OF BROWARD PUBLIC NOTIFICATION AFFIDAVIT I,, do swear and affirm: (Print Name) 1. That I have mailed Public Notices to adjacent property owners within four hundred feet (400 ) of the project. (Name of Project) 2. The Public Notice informed adjacent property owners that there will be a public hearing held before the City s Planning Board/City Commission on, 20 for the project. (Name of Project) Affiant Signature Sworn to and subscribed before me this day of, 20. Notary Public State of Florida Seal/Stamp Type or Print Name of Notary My Commission Expires: