Office of the Deputized Zoning Administrator

APPLICATION FOR LOCATIONAL CLEARANCE/

CERTICATION OF ZONING COMPLIANCE

BASIC REQUIREMENTS
1. Duly accomplished and notarized Application Form
2. Any of the following requirements relatives to right over land:
2.1 Photocopy of the certificate of title,in case registered in the name of the applicant;
2.2 In the absence of any existing certificate of the title in the name of the applicant, submit:
2.2.1 Certified true copy of the latest tax declaration
2.2.2 Pro-format affidavit (see attached form)
2.3 In case the property is not registered in the name of the applicant, submit a photocopy of the owner’s
certificate of title or in the absence of title, the tax declaration and pro-forma affidavit as described in
item b. any of the following:
2.3.1 Duly notarized deed of sale or deed of donation
2.3.2 Contract of Lease
2.3.3 Authorization to use land, whichever is applicable
3. VICINITY MAP showing the existing land uses within the minimum of 100 meters and 1-kilometer radius
from the lot boundary of the project site for projects of local and national significance, respectively.
4. SITE DEVELOPMENT PLAN showing the project site lot area boundaries and proposed layout of
improvements therein.
5. Environmental Compliance Certificate / Certificate of Non-Compliance (ECC/CNC)
6. BILL OF MATERIALS
7. Locational Clearance FEE

ADDITIONAL REQUIREMENTS
8. For LGUs that have assumed HLURB devolved functions: Zoning Certification issued by the HLURB
Regional Officer indicating that the project site is within the area zoned as non-agricultural per approved/
ratified CLUP/ ZO
9. Barangay Clearance for Construction
10. Barangay Clearance for Business
11. Building plans (in A3 or A0 size sheets)
12. Manufacturing projects:
a.) DESCRIPTION OF INDUSTRY citing among others the following:
b.) Types and volume of raw materials/chemicals used;
c.) Products manufactured or stored:
d.) Average production output/capacity per day/week/month:
e.) Average production output/capacity per day/week/month:
f.) Industrial wastes and plans for pollution control;
g.) Description of process flow or manufacturing process.
h.) Manpower Requirements
13. Corporations:
a.) SEC Registration
b.) Articles of Incorporation
c.) Constitution and By-Laws
d.) Secretary’s Certificate authorizing company’s representative to sign/ apply
14. For special projects requiring consideration of the community
a.) Neighborhood Consent within 100m radius of the establishment
b.) Barangay Resolution of No Objection (for Construction or Business)
15. Other additional documents as may be required pursuant to guidelines of the Department of Human
Settlements and Urban Development (DHSUD)
a.) Amendments to the Implementing Rules and Regulations Governing the Processing of
Applications for Locational Clearance of Markets (R-682 s.2000, R-729 s.2002)
b.) Amending Article 5 Sections 13,14,18, and 19 of the Model Zoning Ordinance (MZO) to
include Slaughterhouse/ Abattoir as an Allowable Use (R-650 s.1999)
c.) Amendments to the Implementing Rules and Regulations Governing the Processing of
Applications for Locational Clearance of Poultry and Piggery (R-674 s. 2000, R-729 s. 2002)
d.) Revised Locational Guidelines for Base Stations and Other Infrastructure for Cellular Mobile
Telephone Service, Paging Service, Trunking Service, Wireless Local Loop Service, and
ZAD-LC-CZC-Form, 8/15/2021.
 Office of the Deputized Zoning Administrator

Other Wireless Communication Services (DHSUD Order No. 2020-009)

e.) Amending Implementing Rules and Regulations to Govern the Processing of Applications
for Locational Clearance of Funeral Establishments (R-638 s. 1999)
f.) Rules and Regulations for Memorial Parks/ Cemeteries
g.) Other locational guidelines
16. For projects requiring Consent of nearby residents:
a.) Neighborhood Consent within 50-100m radius of the establishment
b.) Barangay Resolution of No Objection (for Construction or Business)
17. For applications filed by authorized representative:
a.) Sworn Special Power of Attorney for the representative to file/follow up application, and to
claim decision on the application.
b.) Other additional documents as may be needed for project of national significance which
require a more exhaustive evaluation.
18. Other requirements as needed

ZAD-LC-CZC-Form, 8/15/2021.
 Office of the Deputized Zoning Administrator

APPLICATION FOR LOCATIONAL CLEARANCE/

CERTICATION OF ZONING COMPLIANCE

1. Name Address

2. Name of Corporation Address

3. Name of Authorized Representative Address

4. Project Type 5. Project Nature

New Development
Improvement
Others/ Specify :
6. Project Location (No./ Street/ Brgy/ Mun/ Prov) Lot Area :

7. Project Area Lot Area :

(in Square Meters, Building(s)/ Improvement)

8. Right Over Land 9. Project Tenure

Owner Permanent
Lessees Temporary (Specify Year)
Others/ Specify
10. Existing Land Use of Project Site
Residential Industrial Vacant/ Idle
Institutional Others/ Specify Agricultural (Specify crops):
Commercial Tenanted Not Tenanted
11. Project Cost/ Capitalization (in pesos, write in words and figures)
Php
12. Is the project applied for the Subject of Written Notice(s) from this Office and/ or its Deputized Zoning
Administrator to the effect requiring for presentation of locational clearance/ certificate of zoning
compliance (LC/CGZ) or to apply LC/ CSZ?
Yes No
If Yes, please answer the following :
12a. Name of HLURB Officer or Zoning Administrator who issued the Notice(s) :
12b. Date(s) of Notice :
13. Is the project applied for the Subject of similar application with other offices of the commission and/
or deputized zoning administrator?
Yes No
If Yes, please answer the following :
13a. Other HLURB Office(s) where similar application(s) were filed :

13b. Date(s) filed :

13c. Action(s) taken by Office(s) mentioned in 13a :

14. Preferred Mode of Release of Decision

Pick-up By Mail, addressed to :
Applicant Authorized Representative :
15. Signature of Applicant 16. Signature of Authorized Representative

Republic of the Philippines

_____________________

SUBSCRIBED AND SWORN TO before me this ____ day of ______________ 20__ in the City/
Municipality of _________________, ___________ affiant exhibiting to me his/ her Residence Certificate
No. ____________ issued at __________________, issued on _____________.
NOTARY PUBLIC

ZAD-LC-CZC-Form, 8/15/2021.
 Office of the Deputized Zoning Administrator

AFFIDAVIT

I, ________________________________ of legal age, single/married, Filipino citizen, with postal

address and residence at ____________________________ after being sworn to in accordance with
law, do hereby depose and state THAT:

1. I am the owner of a parcel(s) of land located at _________________________ with an

area of _____________ square meters, covered by Tax Declaration
no.(s)___________________;

2. The above-mentioned property(ies) is/are the subject of an application for Locational

Clearance for ______________________________(Project type).

3. The above-mentioned property(ies) was/were acquired by the way

_____________________________(state whether by sale or inheritance, etc.) but has/have
not been issued certificate(s) of title considering the following reasons:
____________________________________________;

4. To the best of my knowledge, the said property(ies) is/are situated within alienable and
disposable lands and outside lands of the public domain and the same is/are now utilized for
agricultural purposes, particularly for the cultivation _______________________________
(indicate crops) and is/are [ ] tenanted [ ] not tenanted.

5. Further, to the best of my knowledge, the above-mentioned property(ies) is/are free from
any alien or encumbrance other than ___________________________________ (indicate
liens and encumbrances, if any)

6. I am executing this affidavit to attest to the veracity of the above-mentioned facts and in
compliance with the requirements of the Housing and Land Regulatory Board or
Sangguniang Bayan relative to the application for Locational Clearance for the
above-mentioned project.

Affiant further sayeth naught.

In witness whereof, I have set my hands this __________ day of _________________, 21_________ at
___________________________________, Philippines.

AFFIANT

SUBSCRIBED AND SWORN TO me this ______ day of _______________21_______, affiant exhibiting

to me his/her Residence Certificate No. _____________issued at _______________on
__________________.

NOTARY PUBLIC

ZAD-LC-CZC-Form, 8/15/2021.