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Form - Application Zoning Clearance

Application for for the issuance of locational clearance

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Neilbrann Columna
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379 views1 page

Form - Application Zoning Clearance

Application for for the issuance of locational clearance

Uploaded by

Neilbrann Columna
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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Republic of the Philippines

Province of Cagayan
MUNICIPALITY OF LAL-LO

APPLICATION FOR LOCATIONAL CLEARANCE


1. NAME OF APPLICANT 2. NAME OF CORPORATION

3. ADDRESS OF APPLICANT (Number, Street, Barangay, City/Municipality, 4. ADDRESS OF CORPORATION (Number, Street, Barangay,
Province) City/Municipality, Province)

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

7. PROJECT TYPE 8. PROJECT NATURE


New Development Others (Specify) __
Improvement
9. PROJECT LOCATION (Number, Street, Barangay, Municipality, Province) 10. PROJECT AREA (in square meters)
Lot:
Building & Facility:
11. RIGHT OVER LAND 12. PROJECT TENURE
Owner Others (Specify) Permanent
Lease Temporary (Specify Years)
13. EXISTING LAND USES OF PROJECT SITE
Residential Industrial Tenanted
Institutional Agricultural (Specify crop) Not Tenanted
Commercial Vacant/Idle Other (Specify) _______
14. PROJECT COST/CAPITALIZATION (In pesos, write in words and figures)

15. IS THE PROJECT APPLIED FOR THE SUBJECT OF WRITTEN NOTICE(S) FROM THE ZONING ADMINISTRATOR
FOR THE EFFECT REQUIRING FOR PRESENTATION OF LOCATIONAL CLEARANCE OR APPLY FOR LOCATIONAL
CLEARANCE?
YES (Please indicate the following) NO
Issuing Officer
Date/s of Notice/s:
Orders/request indicated in the Notice
16. IS THE PROJECT APPLIED FOR THE SUBJECT OF SIMILAR APPLICATION(S) WAS/WERE FILED
YES (Please indicate the following) NO
Other Office(s) where similar application(s) was/were filed:
Date(s) Filed:
Action Taken:
17. PREFERRED MODE OR RELEASE OF DECISION
Pick-Up by Applicant by Representative (needs Authorization)
Mail to my address
18. SIGNATURE OF APPLICANT 19. SIGNATURE OF AUTHORIZED REPRESENTATIVE

Applicant Authorized Representative

Republic of the Philippines )


Province of Cagayan ) S.S.
Municipality of )

SUBSCRIBED AND SWORN to before me this day of , 20 in the Municipality of _____________,


Province of ______________, affiant exhibited to me his/her Community Tax Certificate No. issued at ________________
on .

Notary Public

Doc. No.
Page No.
Book No.
Series of

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