Application No :___________________________
Date Received :___________________________
O.R. No. :___________________________
Date Issued :___________________________
Amount Paid :___________________________
OFFICE OF THE CITY PLANNING AND DEVELOPMENT COORDINATOR
OFFICE OF THE ZONING ADMINISTRATOR
CITY OF IMUS, CAVITE
LOCATIONAL CLEARANCE/ZONING COMPLIANCE APPLICATION FORM
BOX 1 Applicants Information
Name of Owner (Last, First Middle)
Address of Owner Telephone Number
Name of Corporation (If not Single Proprietorship)
Address of Corporation Telephone Number
Representative /Contact Person (Last, First Middle)
Representative Address Telephone Number
Applicants Right Over Land Date of Filing
( ) Owner ( ) Lessee ( ) Loan ( ) Others (specify)
____________________________
BOX 2 Project Description
Project/Business Title Business Type PROJECT STATUS
( ) New ( ) Renovation ( ) Expansion
Location (No., Street, Barangay)
Lot Area Floor Area No. of Storey
Project Coast/Initial Capitalization
BOX 3 Conformity
“We hereby certify to the above information and further declare under the penalties of perjury that the same has been formulated to good
faith verified by me and to the best of my knowledge and belief is true and correct.”
APPLICANT
Print Name (Family, First Middle)
Res. Cert. No. Date Place
Signature
Republic of the Philippines)
City of Imus, Cavite ) S.S.
SUBSCRIBED AND SWORN TO before me this ______ day of __________________, 20___ in the City of Imus, Province of Cavite, affiant
exhibits to me his/her Residence Certificate No. ____________________ issued at ________________________ on ___________________, 20___.
Doc No.________
Page No._______
Book No._______
Series of _______
LIST OF REQUIREMENTS
DOCUMENTS SUBMITTED REMARKS DOCUMENTS SUBMITTED REMARKS
Notarized Application Form Xerox Copy of TCT/Deed of Sale/Contract to Sell
Notarized Affidavit of Parking Xerox of Tax Dec./Tax Receipt
Barangay Endorsement/Resolution Xerox of Contract of Lease and TCT
Homeowners/President or Board Endorsement Complete Sets of Construction Plan,
Xerox Copy of DTI/SEC Bill of Material and Specification.