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Petition for Special Use Permit

2. Village of Skokie
   Skokie Plan Commission (847/933-8447)
3. 
5. Petition for Special Use Permit
7. APPLICATION MUST BE COMPLETE IN ORDER TO SCHEDULE A HEARING DATE
9. Name of proposed use or development:*
10. Zoning:
12. Address of property:*
14. Existing use(s):*
15. Proposed use(s) in Appendix A:*
17. Comprehensive Plan Sector (select):

    1. A
    2. B
    3. C
    4. D

    1. E
    2. F
    3. G
    4. H
18. Comprehensive Plan Designation:
20. All property identification numbers (PINs):
22. Petitioner Information
24. Name(s):*
26. Street address:*
27. City, State, Zip*
29. Email:*
30. Phone:*
31. Fax:
33. Agent or Attorney Information (if other than petitioner)
35. Name:
37. Street Address:
38. City, state, zip:
40. Email:
41. Phone:
42. Fax:*
44. THE LEGAL TITLEHOLDER MUST SIGN THIS PETITION. Where the property is held in trust, the trust officer must sign the petition and include a letter naming all beneficiaries of the trust and authorizing the beneficiaries to act on the matters related to this petition request. The undersigned acknowledges and agrees that all documentation submitted with this application becomes public record and may be viewed by the public. The undersigned understands and agrees that if a special use permit/site plan approval is granted to this application, that the special use permit/site plan approval ordinance, and any conditions contained therein, shall be recorded at the petitioner’s expense in the Office of the Recorder of Deeds for Cook County and that failure to comply with any and all terms and conditions of the special use permit/site plan approval shall be cause to initiate hearings to consider revocation of the special use permit/site plan approval, as well as any related business license, as provided for in the Village of Skokie Code.
46. Any required fees or monies owed by the applicant to the Village must be paid as a condition of approval.
48. Legal titleholder(s) of property:
    (Names, Trust Number and Beneficiaries, Corporation, etc.)
50. Electronic Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
52. Titleholder's signature(s):*
53. Date:*
55. Titleholder's street address:
57. Titleholder's city, state, zip:
59. Email:
60. Phone:
61. Fax:
63. SUBMITTAL REQUIREMENTS
    The below documents must be mailed and/or delivered to the Community Development Department, Planning Division 5127 Oakton Street • Skokie, IL 60077
65. 1. List all aspects of the proposed development that do not conform to the requirements of the Village of Skokie Code.
    (Code Section, Code Requirement, Requested Relief)
67. 2. Current proof of ownership – current title policy or tract search (dated less than 3 months from application) Visit www.realinfo.net to obtain ownership information for each Property Identification Number (PIN) associated with the proposal.
     If legal title is in trust, list the names of the beneficiaries  If legal title is in a corporation, list the names of the principal officers and directors
69. 3. Letter of authorization from the titleholder – when someone other than the titleholder (or beneficiaries) or the titleholder’s attorney presents the principle testimony at the public hearing
71. 4. A statement of the effects of the proposed use upon the character of the neighborhood, surrounding property values, traffic conditions, public utilities, storm water detention, and other matters pertaining to the public health, safety, morals and general welfare of the community. Give reasons to support your statements.
73. 5. Check made payable to "Village of Skokie" for application fees and applicable recording fees.
75. 6. 1 full size plan, 3-11”x17” copies, and 1 .PDF file of the following:

    1. Site plan, drawn to scale, showing buildings, parking spaces, and all other significant data with all pertinent dimensions fully noted.
    2. Floor plans, drawn to scale, of the building for the proposed use. If the building is multitenant, indicate the gross floor area of portions of the building used by the petitioner and other uses.
77. 7. 1 full size plan, 3-11”x17” copies, and 1 .PDF file of the following:

    1. Plat of survey by an Illinois Licensed Surveyor showing all existing site improvements and easements.
    2. Landscape plan and plant list showing location, genus, species, common name, and sizes of all existing and proposed landscape items
    3. Detailed elevations of the outside appearance of new or altered structures
79. 8. 3-11”x17” color copies and 1 .PDF file of architectural renderings if a new or altered structure
81. 9. 3 copies of a Traffic Impact Analysis (if required by Traffic Engineering Division)
83. 10. Photographs of the area involved (if necessary)
85. Additional print and electronic copies of all required final plans, renderings, and elevations as approved or modified by the Plan Commission may be required if this case is heard by the Village Board.
87. NOTE: Evidence of personal notice to surrounding taxpayers of record within 250’ of the subject site and occupants of the subject site will be required prior to the Plan Commission hearing. The notice shall be delivered by regular mail not more than 45 days nor less than 15 days prior to the hearing. It is recommended that the notice list be reviewed by Staff at least 17 days prior to the public hearing. The Village of Skokie is not responsible for an incomplete or incorrect notice.
89. Please call the Community Development Department with any questions (847/933-8447)
Leave This Blank:


91. 1. Receive an email copy of this form.
92. Email address

    This field is not part of the form submission.

93. Submit Submit and Print

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