RRvsed 25 of March 2011,
City of Makati
URBAN DEVELOPMENT DEPARTMENT
Zoning Administration Di
APPLICATION FORM FOR LOCATIONAL CLEARANCE
Application for: [—] Business [] Building Zoning Cerificate [—] NCC (Bldg / Bus) [] Others:
T. INFORMATION (Piease Print Leaibly)
Business Name / Project Title:
Line of Business / Type of Construction:
Location:
(univHiouse Noy Gallding Name) eaeressy TBarangayNilaga)
Owner: Landline No.:
Authorized Representative Landline No.:
Note: Authorized Representative must present ID and Authorization in claiming the Locational Clearance.
Il, REQUIREMENTS (0o not fil-up)
BUSINESS BUILDING
raced coh
Vicinity / Location Map 7 Sets Architectural Plans (Signed/Sealed/Folded)
Barangay Clearance (Business) Barangay Clearance (BUI)
Lease Agreement Lease Agreement
L_] pri/secarticies Real Property Tax Receipt (Latest)
Occupancy Permit (Building/Unit) (J cctitet/ oct DENR Certification (2 sets)
Real Property Tax Receipt (Latest) (_] Tax Deciaration
CCT/TCT/ OCT/ DENR Certification ‘Authorization Letter (for representative)
Tax Declaration Others
‘Authorization Letter (for representative)
Others
Peaibeiion Reenkeadine PRE EVALUATION CONTROL NO.:
Action to be taken: Inspection [__] Processing
Note: Locational Clearance will be ready for release within two (2) days provided all requirements are
complete and no site visitiverification is,necessary. Otherwise, you may follow-up your application
on at telephone number 870-1734.
MI. APPLICANT'S DECLARATION (To be notarized prior to fling of application)
hereby certify that the above given information are true and correct to my own personal knowledge and that any
misrepresentation or misdeclaration shall render this application null and void. | also understand that failure to complete
or comply with any of the other requirements will result in delay and disapproval of the application.
‘Applicant / Representative Position / Title
(Signature over Printed Name)
‘Subscribed and sworn before me this day of. 20 __at the City of Makati affiant exhibited to
me hisiher Residence Certificate No. issued at on 7
oc. No.
Page No.
Book No.
Series of 20
www.makati.gov.ph Makati, Mahalin Natin... Atin Ito.