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LJtKE
COUNTY,
FL
REAL
FLORIDA ·
REAL
CLOSE
Office of
Planning and Zoning
Application for Capacity Reservation Certificate
Internal Use Only:
Application Request Number: Project Number:
For those developments that (1) are not subject to a Vested Rights Determination or (2) exceed De Minimis
thresholds as outlined in the Lake County Land Development Regulations, Chapter 5.
Items to include:
Packet items:
A copy of the valid Capacity Encumbrance Letter Site Design Information, if applicable
Warranty deed for each parcel included on this Property record card for each parcel included on
application this application (http://www.lakecopropappr.com/)
(http://www.lakecountyclerk.org)
Application Fee: made payable to “Lake County Board of County Commissioners”
$165.00 (non-refundable) Capacity reservation fee (equivalent to the estimated applicable impact
fees). Please contact Development Processing at (352) 343-9855 for an
estimate.
Application and Owner Information:
An Owner’s affidavit must be submitted if the applicant is different from the property owner.
Application Date:
Building Permit Number (If Available):
Applicant:
Phone Number:
Contact Person: Additional Contact Name:
Address:
City: State: Zip:
Owner:
Phone Number:
Address:
City: State: Zip:
Office of Planning & Zoning Revised 2017/10
Capacity Reservation Certificate Page 1 of 2
Application Request Number (From Encumbrance Letter):
Project Number (
Assigned by County):
Property Information (please attach a locator map):
Project Name:
Alternate Key No.: Total Acreage:
Future Land Use Designation:
Existing use of the subject property:
Proposed land uses:
Square footage: Number of Units:
Will this project be phased (if yes, please provide number of units/sq. ft for each phase)? Yes
Phase I: No. of Units: Sq. ft.: Allocation of capacity:
Phase II: No. of Units: Sq. ft.: Allocation of capacity:
Phase III: No. of Units: Sq. ft.: Allocation of capacity:
Name of DRI, PUD, office park, if applicable:
No
Capacity Information:
Applicant Name:
Applicant Signature:
Title:
Date:
Mailing Address: Office of Planning and Zoning
PO BOX 7800, Suite 510
Tavares, FL 32778
Office of Planning & Zoning Revised 2017/10
Capacity Reservation Certificate Page 2 of 2
click to sign
signature
click to edit