Page 1 of 4 (2018)
Name: ________________________________________ Phone: _________________________
Company: ____________________________________ Fax: ____________________________
Address: ______________________________________ Email: ___________________________
Name: ________________________________________ Phone: _________________________
Company: ____________________________________ Fax: ____________________________
Address: ______________________________________ Email: __________________________
Property Owner
Name: ________________________________________ Phone: _________________________
Address: ______________________________________ Email: __________________________
Property Owner Signature:
X._________________________________________________ Date: _____________
If a legal representative signs for a property owner, please attach an executed power of attorney.
Proposal Information
GPIN(s): _________________________________________________________________________
Address (or location description): _________________________________________________
Acreage: ____________ Zoning (Current): __________ Zoning (Proposed): __________
Deed Book and Page #: ____________
*Attach any existing zoning conditions or
T o w n o f A s h l a n d
Date: ________________
Case # and Name:
Department of Planning and Community Development
101 Thompson Street
Ashland, Virginia 23005
(804) 798-1073
fax: (804) 798-4892
$1,100 + $50 per acre or part thereof
$1,500 if TIA required
Amount Paid: ______________________
Date: ______________________________
X. __________________________________
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Rezoning Process
Prior to submitting a rezoning applicaiton, the applicant is strongly encouraged to
meet with staff for a pre-application meeting by calling 804-798-1073.
Also, any proffer amendments will follow the rezoning process described below.
This chart is not comprehensive, as
there are special procedures
which apply to certain zoning
districts. Please contact staff at
the Town of Ashland Planning
Department with any questions.
Application C ompletion
Sub mit applic at ion to Plann ing
Depa rt men t . Staff w ill review for
completi on. Applicant will be
notifi ed when de em ed co mpl et e.
Planning Comm ission
A pub lic heari ng is h el d. Staff will p res ent t heir
rec omm endat ion t o the Co mmi ssion, t hen the
applicant and oth er citizens may speak . The
Commi ssi on will vot e on a reco mmendati on to
the Town C ouncil . Plann ing Co mmi s sion m ust
rep ort recomm enda tion to c oun cil w it hi n 100
days a ft er t h e fir st p ublic h earin g .
Public hearing advertised in local paper and notices
sent to abutting property owners, per 15.2-2204
Sta ff Re view
Appl icat ion forwarded t o Town,
Coun t y and other departm ent s (if
nece ssary) for review. Com men ts
will be provi ded to applicant and
forw arded on to Plann in g
Commi ssi on.
Town C ou nc il
A public hearin g is held. Appli can t may speak
on th ei r behalf . Staff pre se nt s applicati on and
rep ort ; Council r eviews an d pro vid es a final
ruli ng .
Rec ord at ion
A letter noting the outcome of the Town Council
hearing will be sent to the applicant. If approved,
finalized proffers (if necessary) and ordinance will need
to be signed and notarized before recordation at the
Hanover County courthouse.
Public hearing advertised in local paper and notices
sent to abutting property owners, per 15.2-2204
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Proposal Description
Answer the following questions in the space provided below or attach a narrative
that addresses each question specifically.
1. What is the existing or past use of the property?
2. What are the proposed uses and/or improvements?
3. Why is this location desirable? How will you mitigate any effects on
surrounding properties (e.g. Traffic, Light, Sound, Noise, Visual Landscaping,
Signage, Stormwater, etc.)?
4. How is this rezoning compatible with the Comprehensive Plan?
*If not specifically required in the zoning ordinance, submitting a sketch plan or
other visual details for your proposal is highly encouraged.
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Adjacent Property Information
Surrounding property owner information can be found by searching online for
Hanover County GIS, and viewing parcel level ownership information.
GPIN (Parcel ID)
Owner name
Proffer Statements
Statement of proffers for rezoning must include the following:
_______________________________________________, OWNERS OF Tax Parcel/GPIN
_______________________ hereby voluntarily proffer for themselves, their personal
representatives, successors and assigns hat, in the event that the subject property
(referred to as “the Property” is rezoned from ___________ to ___________, the
development and use of the Property will be subject to the following conditions:
Notary statement for proffers (must provide at end of proffer statement):
These proffers are being submitted prior to the Ashland Town Council Public Hearing
on this request, scheduled to occur on _____________________________.
_____________________________ ___________________________
Applicant Signature Date
To wit:
I, __________________________________, a Notary Public for the State of Virginia, do
certify that ______________________________________, whose name is signed to the
above, bearing date on the _____________ day of _______________, _________, has
acknowledged the same before me in my State aforesaid.
Given under my hand this ______ day of ____________________, ____________.
My Commission expires __________________________
Registration No. ________________________________