2. Date of Request*
   Date of Request
5. Address of Request*
   Street Address, City, State, Zip Code
9. Applicant Information
11. Name of Applicant*
13. Applicant is...
    -- Select One --Property OwnerDeveloperEngineerOther Representation
15. Mailing Address of Applicant*
    Street Address, City, State, Zip Code
17. Telephone Number of Applicant*
19. Email Address of Applicant*
21. Owner's Affidavit
    If applicant is not property owner, please provide an owner's affidavit.
25. Property Owner Information
    If Applicant is property owner, skip section.
27. Name of Property Owner
    per Assessor's Records
29. Mailing Address of Property Owner
    Street Address, City, State, Zip Code per Assessor's Records
31. Telephone Number of Property Owner
33. Email Address of Property Owner
37. Existing Site Conditions
39. Parcel Identification Number*
    Per Assessor's Records
41. Site Acreage/Square Footage*
43. Zoning District*
    -- Select One --RL- Residential Low DensityRM- Residential Medium DensityRH- Residential High DensityBB- Boulevard BusinessGB- General BusinessI- Industrial
45. Existing Site Conditions*
    Current structures and uses on site.
49. Variance Information
51. Type of Relief Requested*

    1. Variance to the Zoning Ordinance
    2. Appeal from Decision of the Zoning Administrator
53. Proposal*
    Proposed structure, use, site conditions, or other information
55. Zoning Ordinance Subject to Variance*
    Article, Section, Paragraph
57. Provide a detailed narrative for this request below, specifically addressing the following:

    1. Describe any practical difficulties or unnecessary hardships that would result if this request were denied.
    2. Describe any unusual conditions, unique to the property
    3. Describe how the conditions are unique to the property and not so general or recurring so as to have citywide applicability.
59. Specify below:*
    Narrative may be attached separately or filled out above.
61. Narrative Attachment
    Narrative may be attached separately here, or filled out above.
65. 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.
67. List information below*
    The names and addresses above are those of adjacent property owners as listed in the tax records of the City Assessor and County Assessor if applicable.
69. Adjacent Property Owner Information
    Information may be attached here or filled out above.
73. Fee
    The application fee is $1,000. Fee is payable via check (made out to City of Colonial Heights) or in office via card or cash. Application is not complete until fee is submitted.
75. Procedures for Variances and Appeals
    The Board of Zoning Appeals will render a decision within 90 days of filing a complete application. The applicant will receive confirmation when all necessary documents are received for a completed application. Additional information may be submitted by email to payneb@colonialheightsva.gov
77. Approval/Denial
    The Director of Planning & Community Development, as Secretary of the Zoning Board of Appeals, will send a letter to the applicant on the decision of the Zoning Board of Appeals. The letter of approval will include all terms and conditions.
Leave This Blank:


79. 1. Receive an email copy of this form.
80. Email address

    This field is not part of the form submission.

81. Submit

* indicates a required field