Application to the Architectural Review Board

for Certificate of Appropriateness

Village of Mariemont, Ohio - Building Department

6907 Wooster Pike Mariemont, Ohio 45227

513.271.3315 Telephone 513.271.1655 Fax

Received by Building Department:

1. Project Address: ____________________________ Zip:____________Mariemont Zoning: ______________________

2. Owner: ________________________________Street Address:__________________________________

City: ______________________________ State:__________________ Zip:_____________ Phone _______________

Applicant e-mail address:________________________________________________ Applicant Fax No. _________________________________

3. Briefly describe the nature of the proposed work:______________________________________________________________________________

________________________________________________________________________________________________________________________

________________________________________________________________________________________________________________________

________________________________________________________________________________________________________________________

In compliance with the requirements of the Village of Mariemont, Ordinance NO. 0-44-83, the following items must be submitted in support of the application for Certificate of Appropriateness.

(7) copies of a letter stating the description of the proposed design or change of design, use of materials and orientation of the structure.

(7) copies of drawing(s) showing the following information and exactly to scale:

a. All dimension of the property.

b. Structure and buildings on the property with dimensions to property lines.

c. Proposed new work.

d. Properties adjacent to the proposed work with adjacent structure accurately located.

e. List of names and addresses of abutting property owners.

f. Architectural rendering (if requested by Board)

g. Colored elevations (if requested by Board).

h. Application Fee ($25.00).

i. Samples of proposed colors and materials (if pertinent to the Application).

4. Application must be received at the Village Office no later than the Monday, 10 days in advance of the next scheduled Architectural Review Board Meeting. The regularly scheduled meeting time for the Architectural Review Board is the 3^rd Monday of the Month at 7:00 PM in the Village Council Chambers.

5. Applicant or an authorized agent of the Applicant should be present at the scheduled meeting. The Architectural Review Board reserves the right to defer action on any application if adequate documentation is not received for the scheduled meeting.

6. The property may be visited by individual Architectural Review Board members who will telephone prior to coming.

Application by: __________________________________ _____________________________________

(Owner or Agent’s Signature) Applicant’s name – (Print)

Certificate of Appropriateness

Review Date: _______________________________________

q Approved

q Not Approved

q Approved as modified

This Certificate is issued subject to conformance in all respects with the condition of the Application and with the Village of Mariemont Ordinance No. 0-44-83. This certificate may be revoked at any time upon the violation of any of theses provisions.

This Certificate must be conspiciously displayed while Work is in progress.

The Village of Mariemont Architectural Review Board has made the above noted decision by a majority roll call vote on this review date.

________________________________________________________________ __________________________

Chairman, Architectural Review Board Date: