APPENDIX A: REQUEST FOR REASONABLE ACCOMMODATION
REQUEST FOR REASONABLE ACCOMMODATION
This request is per Wahoo Municipal Code Chapter 99, The Rehabilitation Act, The Americans with Disabilities Act, the Federal Fair Housing Amendments Act & The Nebraska Fair Housing Act.
Purpose: To provide or secure equal opportunity to use and enjoy a dwelling and/or otherwise receive services or participate in programs or activities provided by the city when the application of a City of Wahoo building code, fire or safety code, zoning law or other land use regulation, policy or practice acts as a barrier to such equal opportunities.
A request for reasonable accommodation may include a modification or exception to rules, standards and practices when such modification or exception is necessary to eliminate regulatory barriers and provide a person with a disability or handicap with equal opportunity to use and enjoy a dwelling and/or to otherwise receive services or participate in programs or activities provided by the city.
RETURN APPLICATION TO: City Clerk’s Office, 605 N. Broadway, Wahoo, Nebraska 68066. Questions? Contact the City Clerk at (402) 443-3222.
APPLICANT
NAME:                                                                                                                             
STREET ADDRESS:                                                                    
CITY/STATE/ZIP:                                                                                                             
EMAIL ADDRESS:                                                                                                            
PHONE #: (    )                                                                                                                     PROPERTY REQUEST IS BEING MADE FOR
STREET ADDRESS:                                                                                                               
LEGAL DESCRIPTION:                                                                                                           
ASSESSOR’S PARCEL #:                                                                                                       
CURRENT ACTUAL USE OF THE PROPERTY:                                                                            
                                                
LAW, PROVISION, REGULATION OR POLICY FROM WHICH REASONABLE ACCOMMODATION IS BEING REQUESTED:
ATTACHMENTS
   The following items must be ATTACHED to the application.
      •   A statement from the applicant describing the basis for the claim that the individual (or group of individuals, if application is made by an entity acting on behalf of a person or persons with disabilities or handicaps) is considered disabled or handicapped under the Acts.
      •   A statement as to why the requested accommodation is financially, therapeutically, or otherwise necessary to afford a handicapped or disabled person equal opportunity to use and enjoy a dwelling and/or to otherwise receive services or participate in programs provided by the city.
      •   Documentation supporting the financial, therapeutic, or other necessity for the accommodation.
   Dated this                 day of                                   , 20     .
                                                                            
                           Printed Name of Applicant
                                                                            
                           Signature of Applicant
NOTE: Upon the filing of the application, together with all information required above, the City Council shall refer a request for reasonable accommodation to the City Administrator and Mayor who will then together issue a written recommendation to the City Council at a public hearing.
(Ord. 2336, passed 12-26-19)