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621 Cleveland Boulevard • Caldwell, Idaho 83605 • Phone: (208) 455-3021 • www.cityofcaldwell.com/PlanningZoning Type of Review Requested (check all that apply) Administrative Determination Business Permit Certificate of Compliance Home Occupation Mobile Food Unit Lot Line Adjustment Simple Lot Split Temporary Use Time Extension/Renewal Transient Merchant License Other __________________________ Subject Property Information Address: __________________________________________ Parcel Number(s): ____________________________ Subdivision: ___________________________ Block: ______ Lot: ______ Acreage: ______ Zoning: ______ Prior Use of the Property: _______________________________________________________________________ Proposed Use of the Property: ____________________________________________________________________ Applicant Information: Applicant Name (Business Owner): _____________________________ Phone: ___________________________ Address: ________________________________ City: ________________ State: ________ Zip: __________ Email: ____________________________________________________ Cell: _____________________________ Property Owner Name: ______________________________________ Phone: ___________________________ Address: ________________________________ City: ________________ State: ________ Zip: __________ Email: ____________________________________________________ Cell: _____________________________ Agent Name: (e.g., architect, engineer, developer, representative) _______________________________________ Address: ________________________________ City: ________________ State: ________ Zip: __________ Email: ____________________________________________________ Cell: _____________________________ Authorization Print applicant name: ___________________________________________________________________________ Applicant Signature: ________________________________________________ Date: _____________________ STAFF USE ONLY: File number(s): ___________________________ ________________________________________ Project name: ____________________________ Received by: ___________ Date received: _____ Related files: _____________________________