Zoning Permit Application – Form 0100 Fill This Form Out Online or Scroll to the Bottom of this Page for a Printable Copy Zoning Permit Application - Form 0100 Zoning Permit Application - Form 0100 Department of Planning and Zoning P.O. Box 217, Independence, VA 24348 Phone: 276-773-2000 Fax: 276-773-3673 www.graysoncountyva.gov Last Name, First* 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:* 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 Area or Acreage of Parcel:* Describe the type of proposed structure and size of structure*List proposed use(s) of the new structure*Will the structure be used for business or commercial purpose?*New Structures for Commercial/Business Use may require a Commercial Use Application- Form 1000 Please describe business type and/or activity(s): Is the property located in a floodplain?* Yes No Will the structure be in a floodplain?* Yes No If so is the floodplain elevation determined?* Yes No Will the structure be placed at least 35 feet from the centerline of public road/street?* Will the structure be located at least 10 feet from all adjoining property lines? FOR PRIMARY STRUCTURES ONLY- ACCESSORY STRUCTURES DO NOT APPLY *Please fill in or select the response* 1) How many residential structures will be located on the tax parcel?* 2) Is this an application for a manufactured home? Include Form0900Max. file size: 100 MB.3) What type of access?At least 30 feet of road frontage on a state road?* Yes No OR A 30 foot wide legal access to a state road? Yes No OR other- please describe To apply for a zoning permit a site plan sketch on an aerial map (google earth or county GIS) or site plan sketch on a legal survey must be submitted with this application. 1) Please show the proposed structure in relationship to primary access road or right of way. Provide the distance in linear feet of the state road frontage or the legal width of the right of way which accesses the property or other type of approved access. 2) Please depict the property lines on all sides of the property. Please show the location of the new structure in relationship to each of these property lines and include the distance in feet where the new structure will be from each of these property lines. Use arrows to show the distance in feet from all sides to all property lines. 3) Please show the distance of the new structure to the centerline of the public road or street by showing this distance in linear feet from the structure to the centerline of public road or street. Upload Sketch/SitePlan*Max. file size: 100 MB.The Zoning Administrator will visit the site to verify the zoning requirements are met. When property lines are not evident it is the responsibility of the property owner to identify property lines. Please indicate the completion date of this project. The Zoning Administrator will visit the site after this date to insure zoning compliance. Is there open access?* Date of project completion:* MM slash DD slash YYYY I certify that all information listed on this application is true and correct to the best of my belief and knowledge. The approval of a zoning permit is based upon the information provided on this application; any false representation may null and void this permit. By signing this application, I grant permission for an agent of the building or zoning department to visit my site for necessary review and inspections. I understand that any non-compliance may result in potential removal of the structure or a Notice of Violation in accordance with the Grayson County Zoning Ordinance.Date* MM slash DD slash YYYY Signature (Property Owner):* Date* MM slash DD slash YYYY Download (PDF, 37KB)
