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Employment Application

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City of Edgewater
Conditional Use Permit App 1
CONDITIONAL USE
PERMIT
APPLICATION
104 N. Riverside Drive
Edgewater, FL 32132
Planning@cityofedgewater.org
386-424-2400 ext. 1502
Fees: $250.00 Case No.
Applicant Information (MUST BE A PERSON)
Name
Phone
Email
Street Address
City
State
ZIP Code
Property Owner Information (if different from applicant)
Name
Phone
Email
Street Address
City
State
ZIP Code
Request
Street Address/Location
Parcel ID No.
Description of Conditional Use
Reason for Request
Required Documents
1. Current Deed
2. Signed and sealed survey showing all existing structures and all new alterations (waterfront property must show the
Mean High Water Line and Wetlands Vegetation Line)
3. Site plan
4. Any other material deemed necessary by the staff
Disclaimer and Signature
Pursuant to Chapter 286, F.S., if an individual decides to appeal any decision made with respect to any matter considered at a
meeting or hearing, that individual will need a record of the proceedings and will need to insure that a verbatim record of the
proceeding is made. The City does not prepare or provide such record.
PLEASE SUBMIT YOUR APPLICATION WITH ALL REQUIRED ATTACHMENTS. SUBMISSIONS OF INCOMPLETE
APPLICATIONS WILL DELAY PUBLIC HEARINGS. APPLICATION FEES ARE NON-REFUNDABLE.
I have read and agree to the terms and conditions set forth in this application.
Owner Signature
Date
Applicant Signature
Date
City of Edgewater
Conditional Use Permit App 2
NOTARIZED AUTHORIZATION OF OWNER (to be completed if applicant is not the property owner)
I/we as the sole or joint fee simple title holder(s) of the
property described as (address or parcel number) authorize
to act as my agent to seek a Conditional Use Permit on the
above referenced property.
Owner’s Signature Owner’s Signature
STATE OF FLORIDA
COUNTY OF VOLUSIA
The foregoing instrument was acknowledged before me on this day of , 20
by who is personally known to me or who has produced
as identification and who did not take an oath.
SEAL
NOTARY PUBLIC
City of Edgewater
Conditional Use Permit App 3
AGREEMENT FOR CONSULTANT, ENGINEERING, PLANNING,
ENVIRONMENTAL, LEGAL, ADVERTISING COSTS & ON-SITE INSPECTIONS
The City of Edgewater contracts for certain consultant, engineering, planning, environmental and legal services
related to its review of development projects. All fees charged by any such consultant, engineering, planning,
environmental, on-site inspections and/or legal service providers are required to be paid by the owner/applicant. In
addition, the owner/applicant is required to pay all advertising and recording costs in connection with application
submitted by the undersigned.
The undersigned agrees that it shall be liable to the City for one hundred percent (100%) of the actual costs, both
direct and indirect, of coordinating and reviewing the application submitted by the undersigned, including, but not limited
to, the following:
Engineering Review and Approval Fees
Planning Consultant Fees
On Site Inspection and Approval Fees
Legal Fees
Advertising Costs
Recording Costs
The owner/applicant does hereby acknowledge that on-site inspections by City staff, consultants, elected and
appointed officials are permitted on said property.
The undersigned agrees to pay the above-referenced fees within thirty (30) days of receipt of an invoice for same
and further agrees to pay to the City interest on the unpaid balance at the rate of one percent (1%) per month for any fees
not remitted within thirty (30) days of receipt of an invoice for same. No site inspections, Development Order or
Certificates of Occupancy will be issued until all of the above-referenced fees are paid in full.
OWNER/APPLICANT:
Signature
Printed Name
Title
Date
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Employment Application

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Completed 14 July 2020

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