Bergen, NY · Genesee County
Special Use Permit Application
The Special Use Permit Application is for applicants asking the Village of Bergen Planning Board to consider a special use permit or another request.
What this form is
Use this application to request a special use permit from the Village of Bergen Planning Board, or to specify another request. It asks for the project address, tax map number, zoning district, any previous appeal, and the purpose and justification for the request. Applicants are asked to include supporting materials, such as site plans, and to certify and sign the application; an owner also signs if different from the applicant.
Who needs it
Applicants seeking a special use permit or another Planning Board request for a Bergen project site should complete this application.
How to submit it
Submit it to the city department named on the form; check the city website for current contact details.
About notarization
This document is signed and dated without a notary; the applicant and, if different, the owner sign the application.
How to submit this form
- 1
Download The Application
Download the Special Use Permit Application PDF.
- 2
Complete The Application
Provide the project site details, previous appeal information, and the purpose and justification for your request.
- 3
Gather Supporting Materials
Include appropriate supporting materials, such as site plans or traffic circulation diagrams.
- 4
Sign And Date
Sign and date the certification; the owner also signs if different from the applicant.
- 5
Submit To The City
Submit it to the city department named on the form; check the city website for current contact details.
Frequently asked questions
- Do I need a notary for the Special Use Permit Application?
- No. The application has signature and date lines for the applicant and, if different, the owner, but no notary block.
- How do I submit the Special Use Permit Application?
- Submit it to the city department named on the form; check the city website for current contact details.
- What information does the application request?
- It asks for the project address, tax map number, zoning district, previous appeal details, and the purpose and justification for the request.
- What supporting materials should I include?
- The form asks applicants to submit appropriate supporting materials, such as site plans, elevations, traffic circulation diagrams, neighborhood land use maps, and other materials that may help the Board.
Need something notarized?
This Special Use Permit Application doesn’t need a notary — but if you have another Bergen form that does, a commissioned online notary can help.