Subdivision Review Fill This Form Out Online or Scroll to the Bottom of this Page for a Printable Copy Subdivision Review Contact Name* First Last Mailing Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Email* Name of Property Owner* First Last Tax Map Number(s):* 911 Address/Site* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Total Acreage of Parcel(s):* Purpose of division:* Classification type:* Zone District: Number of new created parcels: Current Acreage:* Proposed size of new parcels:* Primary Road Access and other access:* New parcel(s) road frontage(s) on primary road:* Proposed use of lots:* Describe any proposed easements/access* Please circle the correct response and comment if necessary.Is the property located in a floodplain? If so are elevations shown?* Yes No Comments: Entrance permit review by VDOT* Yes No N/A Comments: Will 10,000 sq feet of area be disturbed? Erosion and Sediment Control Plan Review?* Yes No N/A Comments: Utility Access* Yes No N/A Comments: Can proposed structures meet the setback requirements of the zone district?* Yes No Comments: Water and Sewer on site or proposed?* Yes No Comments: Current Structures at least 15 ft from lines?* Yes No Comments: Maintenance agreements for streets or HOA?* Yes No Comments: Classification Statement/lines shown on the survey?* Yes No Comments: I certify that the information listed on this application is true and correct, to the best of my belief and knowledge. By signing this application I grant permission for an agent of the Zoning Department and/or official consultants to visit the site for necessary review and inspection of the Subdivision. I understand the requirements for subdivision review and approval as listed in the Grayson County Subdivision Ordinance. I understand that any appeal of the Subdivision Agents disapproval must be in accordance with State Code of Virginia, 1950.Date* MM slash DD slash YYYY Signature (Property Owner):* Download (PDF, 32KB)
