y(Execute in Duplicate) 
 
Application For Certificate of Zoning Compliance 
 
St. Clair County   Zoning Application No.:___________________________ 
Building & Zoning Department    
Office of Director   Application Date:___________________________ 
10 Public Square Belleville IL 62220-1623      
 
Permanent Parcel No:_______________________________ 
 
Zoning fee Paid to: St. Clair County Treasurer $______________________        Date Paid:_______________ 
 
Instructions  to  Applicants:    All  information  required  by  this  application  must  be  completed  and  submitted 
herewith.  Applicants are encouraged to visit the Office of Director of Building & Zoning for any assistance needed 
in completing this form. 
 
1. Name of Owner(s):______________________________________________  Phone No.:_______________    
 
Address:_________________________________________________________________________ 
                                   STREET                                                                CITY                                   ZIP CODE 
2. Applicant(s) Name:______________________________________________  Phone No.:_______________    
 
Address:_________________________________________________________________________ 
                                   STREET                                                                CITY                                   ZIP CODE 
3. Property interest of applicant:    
?   Owner   ?   Lessee   ?   Contractor     ?   Other:_________________________________ 
 
4. Address of proposed construction:____________________________________________________    
 
5. Subdivision:_______________________________________________      Lot Number:___________ 
 
6. Proposed improvement (Check applicable items):    
?   Single Family Residence   ?   Attached Garage 
?   Detached Garage   ?   Basement 
?   Residential Addition   ?   Residential Remodel 
?   Mobile Home: Year______    Title Attached   ?  ?   Garage Addition 
?   Modular Home   ?   2 or 3 Family Residence 
?   Multi-Family No. of Units___________   ?   Carport 
?   Deck   ?   Portable Storage Shed 
?   Pole Barn   ?   Pole Barn Addition 
?   Solar Roof Mount   ?   Solar Ground Mount 
?   Commercial (explain):____________________________________________________________ 
?   Commercial Addition (explain):_____________________________________________________ 
?   Other (explain):_________________________________________________________________ 
?   Brick    
?   Frame    
?   Metal       
 
7. No. of Rooms:_______  No. of Stories:_______ Cost of Improvement:_______________________    
 
Dimensions and Sq. Ft. of Improvement:_______________________________________________ 
 
8. Utilities    Public Water    Public Sewer Service    Well or Cistern    Septic Tank/Aeration   None      ?  ?  ?  ?  ?
 
9. Is any type of business presently operated at this location:    
 
?   Yes (Type)_____________________________________    ?   No 
 
10. Zone district classification:__________________________________________________________    
 
11. 100 year flood classification:_________________________________________________________    
 
12. Use of existing structures:    
?   Residential   ?   Business (Type):____________________________________ 
?   Multi-Family   ?   Industrial (Type):___________________________________ 
?   Agricultural   ?   Other:____________________________________________ 
?   Vacant 

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