Site Plan Review Application -Indian Rocks Beach

Site Plan Review Application

Project Name

Project Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Parcel Identification Number

Parcel Size

Zoning Map Designation

Future Land Use Map Designation

I hereby request Site Plan approval for the following development (Include in the statement the number of residential units, square footage of living space per unit, number of bedrooms per unit and/or the type of amount of non-residential square footage).

Property Owner Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Property Owner Phone

Application Content Checklist

Item

Site Plan

Included

Number of Copies

Location Map

Location Map Included

Sealed Boundary Survey

Location Map Included

Affidavit of Ownership

Location Map Included

Agent of Record

Location Map Included

Subsurface Investigation/ Soil Condition Report

Location Map Included

Building Elevations

Location Map Included

Drainage Plan and Calculations

Location Map Included

Site Plan

Location Map Included

Landscaping Plan

Location Map Included

Filing fee is $800

A digital file will be requested once the plans have been approved.

Provide notice of Name, Title and Certification/Licenses of those providing professional services including Architectural, Engineering, Legal, Planning and Surveying. Each agent must submit an authorization letter as provided on the following page.

Agent #1 Name and Title

Agent #1 Certification/License

Agent #1 Phone

Agent #1 Fax/Mobile

Agent #1 Mailing Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Agent #2 Name and Title

Agent #2 Certification/License

Agent #2 Phone

Agent #2 Fax/Mobile

Agent #2 Mailing Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Agent #3 Name and Title

Agent #3 Certification/License

Agent #3 Phone

Agent #3 Fax/Mobile

Agent #3 Mailing Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Agent #4 Name and Title

Agent #4 Certification/License

Agent #4 Phone

Agent #4 Fax/Mobile

Agent #4 Mailing Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Agent #5 Name and Title

Agent #5 Certification/License

Agent #5 Phone

Agent #5 Fax/Mobile

Agent #5 Mailing Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Agent of Record

Upload Agent of Record

Drop files here or

Max. file size: 100 MB.

Page 11 of PDF form

Affidavit of Ownership

Upload Affidavit of Ownership

Drop files here or

Max. file size: 100 MB.

Page 12 of PDF form

Payment Information

Email(Required)

Billing Address(Required)

Street Address Address Line 2 City State ZIP Code

Application Cost (Required)

Price: $400.00

Processing Fee(Required)

Total

Please note: there is a $3.00 processing fee

Secure Credit Card

Card Holder*

Card Number*

Card Expiration*

Card CVV*