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Locational Clearance Form

This document is an application form for locational clearance or certificate of zoning compliance, requiring details such as the applicant's name, project type, location, and existing land uses. It also includes sections for project capitalization and confirmation of any prior written notices from the zoning administrator. The form must be signed by both the applicant and an authorized representative, and it requires notarization.

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Mert Samarita
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101 views1 page

Locational Clearance Form

This document is an application form for locational clearance or certificate of zoning compliance, requiring details such as the applicant's name, project type, location, and existing land uses. It also includes sections for project capitalization and confirmation of any prior written notices from the zoning administrator. The form must be signed by both the applicant and an authorized representative, and it requires notarization.

Uploaded by

Mert Samarita
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Application No.

: _________________
Date of Receipt : _________________
-------------------------------------------------------------------------------------------------------------------------------------------
APPLICATION FOR LOCATIONAL CLEARANCE/CERTIFICATE OF ZONING COMPLIANCE

1. NAME OF APPLICANT (Last, First, Middle) 2. NAME OF CORPORATION

3. ADDRESS OF APPLICANT 4. ADDRESS OF CORPORATION(Tel. No.)

5. NAME OF AUTHORIZED REPRESENTATIVE 6. ADDRESS OF AUTHORIZED REPRESENTATIVE


(Tel. No.)

7. PROJECT TYPE 8. PROJECT NATURE ( ) New Development


( ) Improvement ( ) Others

9. PROJECT LOCATION (Number, Street, Barangay, 10. PROJECT AREA (In square meters)
City, Municipality, Province) Total Lot Area = ___________________
Total Bldg. Floor Area = _________________
Ground Flr. Area = ________________
11. RIGHT OVER LAND ( ) Owner ( ) Others 12. PROJECT TENURE
( ) Lease ( ) Specify ( ) Permanent
( ) Temporary (Specify years) ------------------
13. EXISTING LAND USES ON PROJECT SITE ( ) Vacant/Idle
( ) Residential ( ) Institutional ( ) Agricultural (Specify crop)
( ) Commercial ( ) Others ____________________________
( ) Industrial ( ) Tenanted ( ) Not Tenanted

14. PROJECT CAPITALIZATION (In pesos, write in words and figures)


_________________________________________________________________________________________
15. IS THE PROJECT APPLIED FOR THE SUBJECT OF WRITTEN NOTICE (s) FROM THIS ZONING
ADMINISTRATOR TO THE EFFECT REQUIRING FOR PRESENTATION OF LOCATIONAL
CLEARANCE/CERTIFICATE OF ZONING COMPLIANCE (LC/CZC) OR TO APPLY FOR
LC/CZC? ( ) Yes ( ) No

16. SIGNATURE OF APPLICANT 17. SIGNATURE OF AUTHORIZED REPRESENTATIVE

________________________________ _________________________________

-------------------------------------------------------------------------------------------------------------------------------------------
Republic of the Philippines ) S.S.
_______________________ ) __________________________________________________________________
SUBSCRIBED AND SWORN TO before me this ___________ day of _________________ , 20________ in the
City/Municipality of _______________________________, Province of ____________________________.
Affiant exhibited to me his/her Residence Certificate No. _______________________ issued at
__________________________ on __________________, 20 ________.

NOTARY PUBLIC

Doc. No. : __________________


Page No. : __________________
Book No : __________________
Series of : __________________

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