Completed revised application form

T:\PLANNING.BRD\Document Library\PB-ZBA Application 3-15-18.doc 1/5 TOWNSHIP OF WEST ORANGE APPLICATION FORM FOR THE PLANNING BOARD OR ZONING BOARD OF ADJUSTMENT A. APPLICANT INFORMATION B. PROPERTY OWNER INFORMATION C. PROPERTY INFORMATION Full Legal Name: Crestmont Country Club, Inc.__________________________________________________ _________ (Last) (First) Mailing Address: 750 Eagle Rock Avenue____________________________________________________________ ___ West Orange NJ 07052(Street) (City) (State) (Zip) Telephone Number: ( ) )Email:____________________________________ Is the Applicant an: Individual, Corporation, Partnership Other _________________________ If the Applicant is a corporation or partnership, a list of the names and addresses of persons having a 10% interest or more in the corporation or partnership must be attached. **See attached disclosure Relationship of the applicant to the property: XOwner, Tenant or Lessee, Purchaser under contract ( with consent of owner, Other (please specify) _________________________________________________ If the applicant is not the owner of the property in question, the applicant must submit an affidavit with the owner(s) authorization to proceed with this process. Check here if same as applicant. If the owner is not the applicant, please complete the following: ___________________________________________________________ Address: ________________________________________________ Telephone Number: ( ) ___________ ______________Email:_____________________________________ Street Address: 750 Eagle Rock Avenue________________________________________ ______ Block Number (s):74 __________________________; Lot Number (s): __________________________; Tax Plate: _____________________________; Zone of Property : R-2_______________________________ The location of the property is at intersection of Eagle Rock Avenue and Laurel Avenue______________and__ ______ __________________________ (closest intersection .) Has there been any previous Zoning Board of Adjustment or Planning Board hearings involving this property? Yes, Date(s): _________________________________________________________________; No If yes, please attach copies of the written decisions adopted by the Board to each application. Please attach a list of all contiguous or adjacent property owned by the applicant or owner. None Yes No 1 1.01 973 232-5061

h copies of the written decisions adopted by the Board to each application. Please attach a list of all contiguous or adjacent property owned by the applicant or owner. None Yes No 1 1.01 973 232-5061 (attorney rick@schkolnicklaw.com Same as applicant X See attached resolutions of approval x X - 501C7 ** Not for ProfitX 121

T:\PLANNING.BRD\Document Library\PB-ZBA Application 3-15-18.doc 2/5 D. TYPE OF APPLICATION E. DESCRIPTION OF PROPERTY Indicate the type of application being submitted, check all boxes that apply. Note that more than one variance may be necessary, please indicate the number of each type needed: 1) Interpretation of ordinance or map. 2) Appeal of action of Zoning Officer. 3) shape of property physical features; exceptional situation. 4) . 5) . 6) Subdivision without variances: major; minor; preliminary; final; preliminary and final. 7) Subdivision with variances: major; minor; preliminary; final; preliminary and final. 8) 9) Amended Site Plan. 10) Conditional Use. 11) Conceptual. 12) Home Professional Office. 13) Home Occupation. 14) Soil Removal Permit. Please list the specific Sections of the Ordinance for which a variance is sought. If additional space is required, please attach a list. Section: ____________; Proposed: ____________; Description: ______________________________________ Section: ____________; Proposed: ____________; Description: _____________________________________ Section: ____________; Proposed: ____________; Description: _____________________________________ Section: ____________; Proposed: ____________; Description: _____________________________________ _ Existing Use of the Property Briefly describe the major elements of your proposal: (a more detailed description is required in Section G.) _______________________________________________________________ _____________________________________________________________________________ ____________ The property is _________________________ (square feet); __________________________________ (acres) Impervious Surface Coverage: Present: _______________________; Proposed: ______________________ Building Coverage: Present: _______________________; Proposed: ______________________ Is the property located: Within 200 feet of another municipality? Yes No Adjacent to an existing or proposed county road? Yes Adjacent to other county land? Yes No Adjacent to a state highway? Yes X No 18.87% 18.87% no change Proposal is to install a 1,248 square foot, three bedroom modular house for seasonal workers. See attached narrative statement Site Plan: preliminary; final; preliminary and final; with variances; without variances.x x Minor site plan Country Club/Golf course 146.7 acres 6.726% 6.76% no

rkers. See attached narrative statement Site Plan: preliminary; final; preliminary and final; with variances; without variances.x x Minor site plan Country Club/Golf course 146.7 acres 6.726% 6.76% no change X X NoX x D-1 use variance 25-24.2b.1c Residential Use Proposal is to install a 1,248 s.f. modular dwelling unit on the Crestmont Ccuntry Club property.

T:\PLANNING.BRD\Document Library\PB-ZBA Application 3-15-18.doc 3/5 F. EXPERTS The following information is respectfully requested to enable the Board to facilitate the processing of this application: S ATTORNEY: _______________________________________________________________ Telephone Number: ( ) _________________________ Email:__________________________________ Address: __________________________________________________________________________________ : _______________________________________________________________ Telephone Number: ( ) _________________________ Email:__________________________________ Address: __________________________________________________________________________________ : _______________________________________________________________ Telephone Number: ( ) _________________________ Email:___________________________________ Address: __________________________________________________________________________________ __________ Telephone Number: ( ) _________________________ Email:_________________________________ Address: __________________________________________________________________________________ OTHER EXPERT(S): ______________________________________________________________________ Telephone Number: ( ) _________________________ Email:__________________________________ Address: __________________________________________________________________________________ If necessary, please list any additional experts below, including address, telephone number and email address. __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ Richard Schkolnick, Esq. 973 232-5061 rick@schkolnicklaw.com Law Offices of Richard Schkolnick, 75 Main Street, Suite 201, Millburn, NJ 07041 Van

______________________________________________________ Richard Schkolnick, Esq. 973 232-5061 rick@schkolnicklaw.com Law Offices of Richard Schkolnick, 75 Main Street, Suite 201, Millburn, NJ 07041 Van Cleef Enginering Associates, LLC 609 689-1100 jbash@vancleefengineering.com 4 AAA Drive, Suite 103, Hamilton, NJ 08691 Lisa Phillips, P.P., AICP prepared attached planning report. Another planner may testify at the public hearing

T:\PLANNING.BRD\Document Library\PB-ZBA Application 3-15-18.doc 4/5 G. REQUIREMENTS FOR VARIANCES H. PLAT SUBMISSION I. NOTICE 4A) PROPOSAL and describe in detail the physical and use changes proposed. 4B) REASONS FOR RELIEF 4C-1, 4C-2 or 4D (Special Reasons) AND part 4E (Negative Criteria). 4C-1) (For C1 variances only) The strict application of the provisions of the Zoning Ordinance would result in the peculiar and exceptional practical difficulties or exceptional undue hardship under N.J.S.A. 40:55D- 70c(1). List in detail wherein this case conforms to this requirement, including, if applicable, reference to the exceptional narrowness, shallowness, or shape of the property, or the exceptional topographical conditions affecting the property which applicant contends warrants the granting of the variance. 4C-2) (For C2 variances only) State how the purposes of the Municipal Land Use Law would be advanced by a deviation from the zoning ordinance requirements and the benefits of the deviation would substantially outweigh any detriment according to N.J.S.A 40:55D-70c(2). Please list all benefits of the deviation to the Township and any adverse effects. State how the benefits of the deviation would substantially outweigh any detriment to the Township. 4D) (For D variances only) State the special reasons under N.J.S.A 40:55D-70d affecting this property. 4E) The granting of this variance will not be substantially detrimental to the public good and will not substantially impair the intent of the zone plan and zoning ordinance. List in detail the reasons, among others, why the variance can be granted without being materially detrimental to the welfare of the community or injurious to the property or improvements of others in the neighborhood and zone. 4F) Please list all maps and other exhibits accompanying this application. Attach an additional sheet if necessary. ITEM SIGNED BY DATE/REVISION Applicant is responsible to publish and serve notice of this application in accordance with Zoning Board of Adjustment/Planning Board requirements; however, notice may not be served until this application is certified as complete and the administrative officer has assigned the applicant a public hearing date. **See attached narrative statement PSite lans (6 sheets) Van Cleef Engineering last revised 4/9/24 **See Attached Project Narrative and Planning Report ** See attached

applicant a public hearing date. **See attached narrative statement PSite lans (6 sheets) Van Cleef Engineering last revised 4/9/24 **See Attached Project Narrative and Planning Report ** See attached narrative statement Not Applicable James A Blash, P.E. **See attached Project Narrative and Planning Rpt.

T:\PLANNING.BRD\Document Library\PB-ZBA Application 3-15-18.doc 5/5 J. VERIFICATION AND AUTHORIZATION SIGNATURE IS REQUIRED FOR ALL OF THE FOLLOWING: I hereby certify that the above statements made by me and the information contained in the papers submitted in connection with this application are true. I am aware that if any of the foregoing statements are willfully false, I am subject to punishment. CONTINUANCE Should the Planning Board/Zoning Board of Adjustment have a full and heavy agenda, or discussion and meeting regarding this application requiring carrying the matter past the statue time limit, the applicant grants permission for such an extension. AUTHORIZATION MUST BE SIGNED I hereby certify that I reside at ___________________________________________________________ in the County of ________________________ and the State of ___________________________________; and that I am the owner of all that certain lot, piece or parcel of land known as Block(s) 174__________: Lot (s) 1.01___ __________ on the Tax Map of _West Orange_____________which property is the subject of the above application, and that said application is hereby authorized by me. Furthermore, I authorize inspection of the site which is the subject of this application. THIS APPLICATION DOES NOT RELIEVE THE APPLICANT FROM COMPLYING WITH OTHER TOWNSHIP ORDINANCES SUCH AS THE TREE REMOVAL ORDINANCE AND OBTAINING THE NECESSARY APPROVALS AND PERMITS UNDER SUCH ORDINANCES. my business address is 750 Eagle Rock Avenue, West Orange, NJ 07052 New Jersey XXXXXXX Essex Crestmont Country Club