Boards & Commissions Application

City of Medina
Planning Department
132 N. Elmwood Avenue
Medina, Ohio 44256
PH (330) 722-9023 * FX (330) 722-9045

Please note: applications will not be accepted as complete by the City of Medina until the applicant and property owner fulfill the requirements listed within the submittal requirements. Application fees are accepted in cash or by check payable to the City of Medina.

*First Name:

*Last Name:

Title:

Company:

*Address:

*City:

*State:

*Zip Code:

*Phone:

Fax:

Email:

*Project Address:

Project Parcel No.:

Project Description:

Planning Commission :

Board of Zoning Appeals:

Historic Preservation Board:

Affidavit of Applicant and Property Owner:
The undersigned do hereby certify that the information to the City of Medina in and with this application is true and accurate and consents to employees and/or agents of the City of Medina entering upon the premises of this application for the purposes of inspection pertaining to the application. Property Owner also consents to posting of a sign seven days prior to the scheduled meeting for public notice for variance, rezoning, code amendment, conditional use requests, and requests subject to a public hearing.

Applicant:_____________________	Property Owner:__________________
Address:______________________	Address:________________________
_____________________________	_______________________________
Email:________________________	Email:__________________________

Any questions regarding this form may be forwarded to Sandy Davis, Administrative Assistant at sdavis@medinaoh.org or (330) 722-0397 or
Greg Hannan, Planning Director at ghannan@medinaoh.org or (330)722-9023.

MEETINGS & NOTICES

LINKS

KEY CONTACT