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Special Use Permit Application
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Special Use Permit Application
The deadline for Special Use Permit applications is the first Tuesday of the month. An application is complete when the fee and all request information is received.
Date of Request
*
Date of Request
Address of Request
*
Street Address, City, State, Zip Code
Name of Project
*
Description of Request
*
Applicant Information
Name of Applicant
*
Applicant is...
*
-- Select One --
Property Owner
Contract Purchaser
Representative of Owner or Contract Purchaser
Mailing Address of Applicant
*
Street Address, City State, Zip Code
Telephone Number of Applicant
*
Email Address of Applicant
*
Purchase Contract
If applicant is the Contract Purchaser, attach contract.
Statement
*
All information is accurate to the best of my ability. By checking this box, you are agreeing to sign and take responsibility for the work on this permit.
Property Owner Information
If applicant is property owner, skip section.
Name of Property Owner
Property Owner Mailing Address
*
Street Address, City, State, Zip Code
Telephone Number of Property Owner
*
Email Address of Property Owner
Other Representative
Provide information for engineer, developer, attorney, or permit expeditor associated with this application. If no other representatives are associated with this application, or information has already been provided in the applicant section, skip section.
Other Representative Contact Information
Provide the name, company, mailing address, telephone number, and email address for all representatives associated with this application.
Parcel Identification
*
Subdivision Lot & Parcel # and/or Tax Map Designation
Site Acreage
Current Zoning
Existing/Proposed Square Footage of Structure(s) (if applicable)
Name of Subdivision
(if applicable)
Proposed Land Use Activity
*
Vehicles per Peak Hour (VPH)
Traffic Impact Analysis
(if required)
Adjoining Property Owners
All adjacent property owner information shall be listed below or separately attached. Please provide property address, property owner name, and property owner mailing address for each adjacent parcel to the subject property. Applicants may submit property cards to satisfy this requirement. Property cards may be printed at the City Assessor's Office. Adjacent property owners include all property across from roadways, watercourses, railroads, and/or municipal boundaries.
List information below
*
The names and addresses above are those of adjacent property owners as listed in the tax records of the City Assessor (or County Assessor, if applicable.)
Adjacent Property Owner Information
Information may be attached here or filled out above.
Narrative
The Comprehensive Plan is available on the City's website within the Planning Department webpage.
What is the Land Use and Transportation Plan Map designation of the subject property?
*
Describe in Detail the Proposed Use of the Property.
*
Explain how this request is consistent with the Comprehensive Plan.
*
List any sensitive environmental or unique features of the property.
*
Explain how this request will impact the surrounding neighborhood and/or the City of Colonial Heights.
*
Have you prepared a conceptual plan of the proposed development, including proposed uses, general lot configurations and road locations?
*
What provisions will be made to provide safe and adequate access to the subject property?
*
Please identify any known or suspected historic resources on both the subject property and adjacent properties.
*
Attachments
*
Check all applicable below:
Adjacent Property Owners Form
Thirteen Copies of the Plat of the Subject Property
Responses to Questions on following page
Owner's Power of Attorney Affidavit, if not applicant
Required $1,500 fee
Traffic Impact Analysis Fee ($500-100VPH or less, $1,000-more than 100VPH)
Attachments
If needed, please email additional attachments to siteplans@colonialheightsva.gov to include with your submission.
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Receive an email copy of this form.
Email address
This field is not part of the form submission.
Submit
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