Application for
Conditional Use Permit
Town of Culpeper, Virginia
Department of Planning and Community Development
400 S. Main Street, Suite 301 Culpeper, VA 22701
Phone: 540-829-8260 Fax: 540-829-8279
Pursuant to the Culpeper Town Code, Chapter 27, Section 27-326,
application is hereby made for a conditional use permit:
Tax Map Number:
Location:
Property
Owner:
Date:
Owner
Address:
Owner
City/State/Zip:
Property Owner(s) Signature:
Administrative Section - DO NOT WRITE BELOW THIS LINE
Relevant Code Section:
Lot Area:
Zoning
District:
Conditional Use Permit #:
Applicant:
Applicant
Address:
Applicant
City/State/Zip:
Applicant
Phone:
Overlay
District:
Described
Proposed
Activity:
PC Hearing
Date/Time:
TC Hearing
Date/Time:
Date of
Approval/Disapproval:
Comments/Conditions
:
Fees Paid:
Amount of
Fees Paid:
Date Staff
Received: