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2. Case Number
3. Permit Number
5. Owner(s) of Record (use additional sheets if more than one-party)
7. Name
8. Phone Number
10. Mailing Address, City, State, Zip Code
12. Email Address
14. Applicant (if different from owner)
16. Name
17. Phone Number
19. Mailing Address, City, State, Zip Code
21. Email Address
23. Agent (if different from owner/applicant)
25. Name
26. Phone Number
28. Mailing Address, City, State, Zip Code
30. Email Address
32. Property Information
34. Tax Map Number
35. Total Acreage
37. Subdivision Name
38. Section
39. Block
40. Lot
42. Physical Address
44. Existing Structures
46. Current Zoning
47. Acreage of Request
49. Proposed Utilities

51. Please provide a copy of a tax receipt showing that taxes on the property are current.

53. Please provide the following:
    1. The General Development Plan (GDP) shall be an accurate survey of the property electronically and paper copy, preferably 11 by 17 or larger prepared by a land surveyor/engineer showing: 
       1. Street address and tax map number of the subject property.
       2. Name, address, and telephone number of applicant.
       3. The size and location of all proposed new construction and all existing buildings on site, drawn to scale and in accordance with an accurate boundary line survey.
       4. Vicinity map at a scale of not less than one inch equals two thousand feet (1” = 2000’) 
       5. The distance to and identification of the nearest street intersection.
       6. Distances and setbacks from the lot lines.
       7. Established street grades and proposed finished grades.
       8. Elevation of lowest floor and building height.
       9. The location of all trees on site that are six inches or greater in diameter at breast height.
       10. The location, design, size and material of all drives and parking areas.
       11. Description of erosion and sediment control plan, if required.
       12.  In the case of demolition, all construction to be demolished and the location and size of all existing buildings and construction to remain on site.
       13. In the case of new construction, points of connection to water and sewer.
       14. In the case of new construction, storm water drainage calculations and disposal in accordance with the Chesapeake Bay Preservation Act.
       15.  Bearings and distances of a scale of 1” = 100’ or less for all property lines and existing and proposed zoning district lines; 
       16. Area of land proposed for consideration, in square feet and acres; 
       17. Scale and north point; 
       18. Names of boundary roads or streets and widths of existing rights of way and utility easements;
       19. Proposed building/parking additions, including any increases of impervious surfaces and improvements to the site;
       20. Vicinity map at a scale of one inch equals two thousand feet (1” = 2000’) or other appropriate size.

    
    

55. Narrative: Answers to these questions shall be required for all conditional use permits. Please use a separate piece of paper with answers typed or neatly printed.
    1. The applicant must demonstrate that the rezoning request promotes the public health, safety, convenience and general welfare of the citizens of the Town in accordance with Sections 15.2-2200 and 2283 (Code of Virginia, 1950, as amended), and the goals and objectives and action strategies of the adopted Comprehensive Plan of the Town. Such demonstration shall be accomplished by providing a narrative which addresses each of these issues.
    2. Describe the effect of this request on (a) adjacent properties, (b) the neighborhood, and (c) the Town in general. Include information concerning: (a) effects on public schools, (b) traffic, (c) public utilities, (d) public health, (e) hours of operation, (f) environmental impacts and (g) existing and future development of the Town.
    3. Describe any existing zoning or conditional use permits and/or variances previously granted to this property.
       1. Topographic contour lines at two foot intervals, for the existing site and after the completion of the proposed development.
       2. The size, location and boundaries of any common open spaces, recreation areas, and recreation facilities, including a statement of whether such open areas are to be dedicated to the public, and the percentage of common area to be green space.
       3. For large scale phased developments, identification of the location and timing of each phase of development.
       4. Description of the methods proposed to control erosion, sedimentation, and storm water runoff.
       5. A listing of the persons to be responsible for future maintenance of all easements, parks, playgrounds, storm water and drainage facilities and common areas.
       6. Identification of the Resource Protection Area (RPA) if applicable and a note stating that all lands in the Town of Colonial Beach that are not RPA are considered a Resource Management Area (RMA).
       7. A plat notation regarding the retention of an undisturbed vegetated 100-foot buffer along all water dependent features.
       8. Delineation of the buildable area on each lot shown on the site plan.
       9. An executed Developer's Agreement to address perpetual maintenance of landscaping and BMP facilities.

    
    

57. Signature(s)

    I/We have read this completed application, understand its intent and freely consent to its filing. The information provided is accurate to the best of my/our knowledge. I understand that the Town may approve, conditionally approve, approved with modifications or deny the request for which I am applying. Furthermore, I grant permission to the Department of Planning and Community Development and any other authorized government agents to enter the property and make such investigations as they deem necessary to evaluate the request and ensure that conditions placed on the request have been implemented and/or maintained as proscribed by the approving authority.  Additionally, if outside review is needed by the Town to evaluate this request I acknowledge and agree to reimburse the Town of Colonial Beach for these outside review agency costs.  

59. Owner/Applicant Signature*
60. Date*
    Date
62. Owner/Applicant Signature
63. Date
    Date
65. Owner/Applicant Signature
66. Date
    Date
68. Owner/Applicant Signature
69. Date
    Date
71. Fees

    Conditional Use Permit:      $800.00                                

72. Total Fees Collected

74. *Note: An application shall not be deemed officially filed until all required plans, plats, fees and supporting documentation are submitted to this department.

Leave This Blank:


76. 1. Receive an email copy of this form.
77. Email address

    This field is not part of the form submission.

78. Submit

* indicates a required field