ANTELOPE COUNTY, NEBRASKA
1. Under the provisions of Article 10 of the Antelope County, Nebraska Zoning Regulations, the undersigned hereby applies for a Conditional Use Permit to establish the following use:
_______________________________________________________________________________.
2. Legal description of property (provide legal description of real estate to be affected by this
application: _________________________________________________________________.
3. This permit application is for the following use:
_____CONFINED ANIMAL FEEDING USE CLASS II PERMIT 1001 TO 2500 ANIMAL UNITS $35.00 fee
Check type of facility proposed and setbacks to be followed:
_____Aerobic=N/S 3/4 mile, E/W ½ mile
_____Covered Anaerobic/Deep pit=N/S 1 mile, E/W ¾ mile
_____Facultative=N/S 1 mile, E/W ¾ mile
_____Anaerobic=N/S 1 1/2 mile, E/W 1mile
_____CONFINED ANIMAL FEEDING USE CLASS III PERMIT 2501 TO 5000 ANIMAL UNITS $55.00 fee
Check type of facility proposed and setbacks to be followed:
_____Aerobic=N/S 1 mile, E/W ¾ mile
_____Covered Anaerobic/Deep pit=N/S 1 ¼ mile, E/W 1 mile
_____Facultative=N/S 1 ¼ mile, E/W 1 mile
_____Anaerobic=N/S 2 miles, E/W 1 mile
_____CONFINED ANIMAL FEEDING USE CLASS IV PERMIT 5001 AND UP ANIMAL UNITS $75.00 fee
Check type of facility proposed and setbacks to be followed:
_____Aerobic N/S1 ¾ miles, E/W ¾ mile
_____Covered Anaerobic/Deep pit=N/S 1 ½ mile, E/W 1 ¼ miles
_____Facultative=N/S 1 ¾ mile, E/W 1 ¼ miles
_____Anaerobic=N/S 3 miles, E/W 1 ½ miles
_____INTENSIVE ANIMAL FEEDING USE CLASS II PERMIT 1001 TO 2500 ANIMAL UNITS
$35.00 fee
There is a N/S ¾ mile, E/W ½ mile setback.
_____INTENSIVE ANIMAL FEEDING USE CLASS III PERMIT 2501 TO 5000 ANIMAL UNITS
$55.00 fee
There is a N/S 1 mile, E/W ¾ mile setback.
_____INTENSIVE ANIMAL FEEDING USE CLASS IV PERMIT 5001 TO 10,000 ANIMAL UNITS
$75.00 fee
There is a N/S 1½ mile, E/W 1mile setback.
_____INTENSIVE ANIMAL FEEDING USE CLASS V PERMIT 10,001 & ABOVE ANIMAL UNITS
$100.00 fee
There is a N/S 3 mile, E/W 1 ½ mile setback.
$100.00 fee______ New Construction_______ Alteration/Enlargement_______ Additional tanks/buildings
Size of new construction/alteration/additional tank or building _____X ______X _______.
4. On the graph paper, provide a site plan (a sketch or drawing) which includes all of the following information (N/A if not applicable):
a. The size, location, and height of all existing and proposed buildings from the centerlines of any adjoining road or property line and the distance between buildings.
b. location of all roads adjoining this property and the distance(s) from the centerline of any road(s) to the point of the proposed building location closest to said road(s)
c. distance to property line(s) of property under different ownership (if less than 300 feet)
d. The types and locations of any easements affecting the property.
e. The location and type of water supply and sewage disposal facilities proposed to serve the building/addition proposed and distance between well and septic tank, and the tile field or other sewage disposal system. Applicant shall check with a certified septic system installer concerning septic system. YES NO NA _______(initials of applicant)
f. Location of any river, stream or intermittent stream within 300 feet of proposed building addition and distance to proposed building/addition
g. The number and location of parking spaces for customers or the public.
h. The location of loading areas.
i. The type and location of refuse collection and storage facilities.
j. The location(s) of residential dwelling(s) and other non-agricultural land uses within two (2)
miles of the property to be affected by the proposed conditional use.
k. List the location and distance to any existing confined feeding use within a 2 mile radius.
l. Location of disposal of dead animals
m. An indication of proposed surface water drainage onto, through and off of the affected
property. Include any areas of the property that are subject to flooding or considered to be wetland.
n. The type, size, and location of all signs associated with such proposed use
5. A CERTIFIED copy of adjacent landowners from an Abstractor shall accompany this permit BEFORE a public hearing is scheduled..
6 I hereby certify that I have the legal authority to file this application, that I have completed and examined this application and know the same to be true and correct. I further certify that all provisions of law and other regulations governing the type of construction and use proposed in this application will be complied with, whether or not specified in this application, including any building, electrical or plumbing codes set forth in the Architects and Engineers Act. _______ (initials of applicant)
7. To avoid any trespassing conflicts, upon signing the application, the applicant will allow the Zoning Administrator, with or without others, the right to enter the property for the purpose of an inspection. _________ (initials of applicant)
___________________________________ _________________________________
Printed name of Applicant Complete mailing address of Applicant
___________________________________ _______________ ______________
Signature of Applicant Date of application Telephone No.
___________________________________________ _________________________________________
Printed name of landowner if different than app. Signature of Landowner if not applicant
Any incomplete permit will be returned to the applicant.
Must be returned to zoning office and fee paid before a public hearing is scheduled
CERTIFICATE OF ZONING COMPLIANCE
This portion to be filled out completely by applicant.
The undersigned hereby applies for a Certificate of Zoning Compliance to occupy and use the premises as follows:
1. Legal description of the property to be affected by the activity proposed: ______________________.
2. Proposed use of premises: ___________________________________________________________.
3. I hereby certify that I have the legal authority to file this application, that I have competed and examined this application and know the same to be true and correct. I further certify that all provisions of law and other regulations governing the type of construction and use proposed in this application have been complied with, whether or not specified in this application.
4. A Certificate of Zoning compliance, once issued, shall remain in effect so long as the use of the land, buildings and structures are used in accordance with said Certificate.
________________________________ _______________________________
Printed name of applicant(s) complete mailing address of applicant(s)
________________________________ _________________ ____________________
Signature of applicant(s) date of application phone # of applicant(s)
CERTIFICATE OF ZONING COMPLIANCE APPLICATION NO. ______________
This certificate of zoning compliance is related to permit no. ___________ issued to _____________________________ and dated ___________________________.
1. If proposed occupancy is a change of use where no new building or additions are proposed and no zoning permit is needed, said building and use will comply with all setback distances, water/sewage disposal requirements, parking/sign regulations and other applicable zoning regulations (refer to requirements on permit) YES NO N/A
2. If proposed occupancy is a change of use where a new building or addition is proposed and a zoning permit is needed, said building and use will comply with all setback distances, water/sewage disposal requirements, parking/sign regulations and other applicable zoning regulations (refer to requirements on permit). YES NO N/A
3. Has building permit been issued, and if so, building and proposed use complies with all conditions of approval? YES NO
4. If use required a Conditional Use approval, building/use complies with all conditions of approval.
YES NO N/A
5. If use required approval of a Variance by the Board of Adjustment, such use complies with all conditions of approval of the approved variance. YES NO n/a
6. Site inspected on _________________ to verify compliance with all applicable conditions.
7. Inspector’s comments: _________________________________________________________________________________.
8. Certificate of Zoning Compliance issued on _____________________.
___________________________________ Zoning Administrator
Copy of approved Certificate of Zoning Compliance mailed to applicant on ____________________.
Revised 2-27-08