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)
