2. Date of Request*
   Date of Request
4. Address of Request*
   Street Address, City, State, Zip Code
8. Applicant Information
10. Property Owner/Tenant
12. Contact Name*
14. Address of Owner*
    Street Address, City, State, Zip Code
16. Telephone No.*
17. Fax No.
19. Email Address
23. Site Plan Information
25. Site Acreage
27. Parcel Identification*
    Subdivision Lot & Parcel # and/or Tax Map Designation
29. Current Zoning
31. Existing/Proposed Square Footage of Structure(s)*
33. Name of Subdivision
    (if applicable)
35. Proposed Land Use Activity*
37. Contract Purchaser*
    (name, address and approval if applicable)
39. Consistency with Provisions of Chapter 286 Zoning:*
41. Statement*

    1. 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.
45. Attachments
47. Attachments

    If additional information needs to be submitted, please email siteplans@colonialheightsva.gov  

49. Attachments*

    Check all applicable below:

    1. Required Review Fee - $100
Leave This Blank:


51. 1. Receive an email copy of this form.
52. Email address

    This field is not part of the form submission.

53. Submit

* indicates a required field