2. Project description, including type, intensity, and amount of development;
3. Phasing schedule (if applicable);
4. Description of requested proportionate fair-share mitigation method(s), and
5. Estimated value of the proposed fair-share mitigation pursuant to Chapter 33 of
the Land Development Regulations.
5. Hurricane Evacuation The subject property occurs in the following hurricane
evacuation zone(s) (check all that apply):
_____ Tropical Storm _____ Category 1 Hurricane ______ Category 2 Hurricane
_____ Category 3 Hurricane ______ Category 4-5 Hurricane ______ N/A
H. Required Permits (check all that apply)
1. _____ FDOT (_____Driveway Access _____ Drainage _____ Utility)
2. _____ Right-of-Way Use (_____) Bay County; ____ City of __________________)
3. _____ Driveway (______) Bay County; _____ City of ____________________)
4. _____ Others (specify): ________________________________________________
I. Understanding of Transportation Concurrency Requirements
I hereby certify that the information contained herein is true and correct and that I am either
the true and sole owner of the subject property, or am authorized to act on behalf of the
true owner(s) in all regards on this matter, pursuant to proof and authorization submitted
with the corresponding development application or attached hereto. I hereby represent that
I have the lawful right and authority to file this application. I understand that submission of
the form initiates a process and does not imply approval by Bay County.
I further certify that I understand that issuance of a Certificate of Concurrency will require
successful completion of Development Review, and that likewise no final development
order will be issued except upon successful completion of this Concurrency Review. I
further understand that “Inquiry Only” Review will result in no Certificate of Concurrency
being issued, and therefore no binding assurance of future capacity, and that a new
Concurrency Review application will be required in conjunction with the first final
development order applies for on this property.
By signing this application, the owner hereby authorizes Planning and Zoning Division staff
to access the subject property to verify information contained in this application and
accompanying submittal documents. Further, the person named as the Project Contact is
authorized on my behalf (if applicable).
__________________________________ _____________________
Owner’s or Authorized Agent’s signature Date
__________________________________
(Please Print or Type Name)
Appendix A: De Minimis Impacts & Minor Transportation Concurrency Review
Bay County Transportation Concurrency Review/ Parker, Springfield
Application Page 4 of 5 09/09 Revised 10/1/12
