APPLICATION NO. __________________________



Thompson Township, Geauga County


The undersigned hereby applies for a zoning certificate for the following described use, said certificate to be
issued by the township zoning inspector on the basis of the information contained within this application.



A:         Name of Applicant:____________________________________________________________________

Address of Applicant:__________________________________________________________________

Telephone Number of Applicant:_________________________________________________________


B:         Name of Owner of Record:______________________________________________________________

Address of Owner of Record:____________________________________________________________

Telephone Number of Owner of Record:___________________________________________________


C.         Address of Property:___________________________________________________________________


D.         Proposed Use:  (check one)

New Construction                   Addition                    Garage             Accessory Building

Residence                             Industrial                   Commercial      Sign, Size



1.  Attach Documentation as to authority to make application

(e.g. deed, power of attorney, lease or purchase agreement)


2.  Attach a legal description of the property, as recorded with the Geauga County Recorder


3.  Attach a site plan or map of lot; drawn to scale, with a north arrow and date showing existing

   buildings or structures and proposed construction or use for which this application is made.

   Width of lot at front line _______ feet                Dimension of Building: Width _________feet

   Width of lot at setback line _____feet                                                    Depth __________feet

   Side yard clearance __________side __________feet  __________side __________feet

   Rear yard clearance __________feet                Front setback line _____________________feet

   Depth of lot from front lot line __________feet                           

   Highest point of building above established grade _____________feet

   Total acreage of property ______________acres



E.        Building:Use_________________________________________________________________________

Number of Stores _____________                                   Basement  ________________________________

Height ___________________feet                                   (Full, Partial or None)


F.        The total amount of square feet of floor space for each floor of proposed buildings or structure on the property
or of any addition or structural alteration to the existing buildings or structures.

First floor ________________ square feetSecond floor ________________square feet

Off street parking space __________________________ square feet.


I hereby certify that all of the information supplied in this application and attachments hereto are true and correct to the best of my knowledge, information and belief.


I hereby acknowledge that I understand that the penalty for falsification is imprisonment for not more than six (6) months, or a fine of not more than one thousand dollars ($1,000), or both.