Special Use Permit Application Fill This Form Out Online or Scroll to the Bottom of this Page for a Printable Copy Special Use Permit Application Special Use Permit Application - Form 0300 Department of Planning and Zoning P.O. Box 217, Independence, VA 24348 Phone: 276-773-2000 Fax: 276-773-3673 www.graysoncountyva.gov 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 (if different) 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 Acreage of Parcel:* *use definition(s) from the Zoning Ordinance*Special Use Permit for:* Zone District:* Please circle the correct response and comment if necessary Is the property located in a floodplain?* Yes No Commercial entrance review by VDOT?* Yes No N/A Building Official consultation?* Yes No N/A Erosion and Sediment Control/Stormwater?* Yes No N/A Will the property and structures meet all other requirements of the zone?* Yes No Water and Sewer review?* Yes No Is the property located in a subdivision or under any previous legal obligations?* Yes No Will hazardous materials be used or present on the site?* Yes No NOTE TO THE APPLICANT: The Special Use Permit application will be reviewed by the Grayson County Planning Commission at their regular monthly meeting. If recommended for approval, the application will proceed to a review by the Grayson County Board of Supervisors. The application may take 2 - 3 months for approval. The State Code of Virginia, 1950 requires that a Public Hearing be held for both the Planning Commission and the Board of Supervisors review of a Special Use Permit. A Public Hearing notice will be issued in the paper announcing the Public Hearing and all adjoining landowners will be notified by certified mail. In order to process the request a complete application, required fee, and a current site plan or survey representing the property must be submitted to the Zoning Department at least 3 weeks prior to the Planning Commission meeting date. Applicants are encouraged to research the potential of the site for the ability to meet all local, state and federal regulations prior to applying for a Special Use Permit. This should include a review of the project by Virginia Department of Transportation for the ability to meet commercial entrance requirements, Virginia Department of Health and/or provider of well and septic services, discussion with the Grayson County Building Official, review of Erosion and Sediment Control/Stormwater where land disturbance is proposed. Any changes to the application once it is received by staff, must be submitted at least 7 days prior to the meeting of the Planning Commission. The applicant or a representative must be present at the meeting at which the application for special use permit is considered. If the decision of the Planning Commission or Board of Supervisors is to be appealed, the applicant should submit an appeal of the decision per State Code of Virginia, 1950, as amended.Present use of the property* Need and justification for the Special Use Permit*Effect of the Special use (if any) on public services and facilities*How will the proposed change effect surrounding properties and the general welfare of the community?*Is the projected use of the property consistent with the zoning districts goals, uses and purpose?*Is the project use consistent with the Comprehensive Plan?*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 to visit the site for necessary reviews and inspection.Date* MM slash DD slash YYYY Signature (Property Owner):* Download (PDF, 36KB)
