Planning and Development
2725 Judge Fran Jamieson Way
Building A, Room 114
Viera, Florida 32940
321-633-2070
Application for Zoning Action, Comprehensive Plan Amendment, or
Variance
Applications must be submitted in person. Please call 321-633-2070 for an appointment at
least 24 hours in advance. Mailed, emailed, or couriered applications will not be accepted.
PZ # __________________________
Existing FLU: _______________________ Existing Zoning: ___________________________
Proposed FLU: ______________________ Proposed Zoning: _________________________
PROPERTY OWNER INFORMATION
If the owner is an LLC, include a copy of the operating agreement.
_____________________________________ ____________________________________
Name(s) Company
_____________________________ _________________________ _______ ___________
Street City State Zip Code
_____________________________________ _____________ _____________
Email Phone Cell
APPLICANT INFORMATION IF DIFFERENT FROM OWNER:
Attorney Agent Contract Purchaser Other ________________
_____________________________________ ____________________________________
Name(s) Company
_____________________________ _________________________ _______ ___________
Street City State Zip Code
_____________________________________ _____________ _____________
Email Phone Cell
2
APPLICATION NAME
Large Scale Comprehensive Plan Amendment (CP) (greater than 10 acres)
Small Scale Comprehensive Plan Amendment (CP) (less than 10 acres)
Text Amendment (CP): Element __________________________________________
Other Amendment (CP): ________________________________________________
Rezoning Without CUP (RWOC)
Combination Rezoning and CUP (CORC)
Conditional Use Permit (CUP)
Binding Development Plan (BDP)
Binding Development Plan (BDP) (Amendment)
Binding Development Plan (BDP) (Removal)
Variance(s) (V)
Administrative Approval of Setbacks, Lot Size, or Accessory Structures
Administrative Approval of Flag Lot or Easement
Other Action: _________________________________________________________
Acreage of Request: ___________
Reason for Request:
3
The undersigned understands this application must be complete and accurate prior to
advertising a public hearing:
I am the owner of the subject property, or if corporation, I am the officer of the
corporation authorized to act on this request.
I am the legal representative of the owner of the subject property of this application.
(Notarized Authorization to Act must be submitted with application)
An approval of this application does not entitle the owner to a development permit.
I certify that the information in this application and all sketches and data attached to and
made part hereof are true and accurate to the best of my knowledge.
_________________________________________ _________________
Signature of Property Owner or Date
Authorized Representative
State of ___________________
County of ________________________
Subscribed and sworn to me before me this ______ day of, _________________, 20 ____,
personally appeared _______________________________, who is personally known to me or
produced _________________________ as identification, and who did / did not take an oath.
______________________________________
Notary Public Signature Seal
4
Office Use Only:
Accela No. ___________ Fee: ___________ Date Filed: ____________ District No. ______
Tax Account No. (list all that apply) _______________________________________________
Parcel I.D. No.
_________ _________ _________ _________ _________ _________
Twp Rng Sec Sub Block Lot/Parcel
Planner: __________________ Sign Issued by: __________ Notification Radius: _________
MEETINGS DATE TIME
P&Z ___________ __________
PSJ Board ___________ __________
NMI Board ___________ __________
LPA ___________ __________
BOA ___________ __________
BCC ___________ __________
Wetland survey required by Natural Resources Yes No Initials ________
Is the subject property located in a JPA, MIRA, or 500 feet of the Palm Bay Extension?
Yes No If yes, list ______________________________
Location of subject property:
Description of Request: