Notice to Applicants for Concurrency Applications
Brevard County Preliminary Concurrency Applications must be submitted and approved prior to Application
for Site Plan, Driveway Permit, Right of Way Permit or Pre-Application for Subdivision.
Instructions for preliminary Concurrency application
All applications shall include:
Concurrency Application Form
Potable Water Service Capacity Availability or Capacity Reservation Form (your choice, we recommend
reservation)
Sanitary Sewer Service Capacity Availability or Capacity Reservation Form (your choice, we recommend
reservation)
Solid Waste Capacity Reservation Form
1 copy of Site Plan or Subdivision Plat
Fee of $175.00 (payable to Brevard County Board of Commissioners)
Sanitary Sewer Service Capacity Availability Certificate or Capacity Reservation Form
Applicant shall fill out information on certificate sections I, II and III and bring it to the agency, that provides
sewer for that location, (Brevard County Utilities, City of Melbourne, etc.). An authorized representative of the
sewer agency must sign the certificate before it is submitted for Concurrency evaluation.
For projects, which will utilize a septic tank or on-site package plant, an authorized representative of the
Brevard County Health Department, Environmental Health Services (Government Center Bldg. A), should sign
the certificate. For projects which have existing public sewer and which will not generate additional flow, a
copy of the account statement will be accepted in lieu of the certificate.
Potable Water Service Capacity Availability Certificate or Capacity Reservation Form
Applicant shall fill out information on certificate sections I, II, & III and bring it to the agency, that provides
water for that location, (City of Cocoa, City of Melbourne, etc.). An authorized representative of the water
agency must sign the certificate before it is submitted for Concurrency evaluation.
For projects, which will utilize a private well, the applicant, under Item V, Private Wells, should sign the
certificate. For projects which have existing public water and which will not generate additional flow, a copy of
the account statement will be accepted in lieu of the certificate.
NOTE: Capacity Availability Certificates are valid only for preliminary conditional approvals. For projects, which
will reserve capacity, including all building permits, Capacity Reservations or paid connection receipts are
required.
Solid Waste Capacity Reservation Certificate
Applicant shall fill out information on certificate sections I, II and III and bring or FAX it to the Brevard County
Solid Waste Management Department, 2725 Judge Fran Jamieson Way, Bldg. Suite A114, Viera, FL 32940,
Phone (321) 633-2042, FAX: (321) 633-2074.
An authorized representative of the Brevard County Solid Waste Department must sign the certificate before
it is submitted for Concurrency evaluation.
NOTE: A Solid Waste Capacity Reservation Certificate is valid for a specific time frame as determined by the
authorized representative of the Brevard County Solid Waste Department.
Please allow 48 hours for the processing of your preliminary Concurrency Application.
The applicant shall pick up and sign for completed reviews unless other arrangements are made in advance.
Preliminary Concurrency Findings of Non-Deficiency without reservation remain valid for a period of 6
months.
Planning & Development Department
2725 Judge Fran Jamieson Way, Bldg A, Suite 114
Viera, FL 32940
Phone: (321) 633-2070, Fax: (321) 633-2074
www.BrevardFL.gov/PlanningDev
APPLICATION FOR CONCURRENCY EVALUATION
OFFICE USE ONLY
District # ________________ Segment # ________________ Review # ___________________
NOTE: This application together with all required attachments shall be completed and submitted to the
Planning & Development Department for Evaluation. The Project must have Concurrency Approval prior to
making application for Site Plan, Subdivision Plat, Driveway Permit and/or a Right of Way Use Permit
Submittal. A finding of Non-Deficiency only entitles the owner/applicant to apply for development permits
pursuant to the time parameters established in the Concurrency Evaluation Ordinance (91-36).
Owner Name _______________________________________________________________________________
Owner Address _____________________________________________________________________________
Home Phone # _____________________________________ Work Phone # ____________________________
Email _______________________________________
Applicant/Company Name ____________________________________________________________________
Engineer __________________________________________________________________________________
Address ___________________________________________________________________________________
Phone # _____________________________________ Fax # _________________________________________
Email _______________________________________
Property Description
Township Range Section Subdivision# Block/Parcel Lot
Acreage Zoning Tax Parcel ID, Legal
Proposed Development Information/Potential
__ Site plan submittal or Amendment Project Name __________________________________________
__ Subdivision plat submittal Nearest major road _____________________________________
Residential Uses (check all that apply)
__
Single-Family Houses Detached
__________du
__
Single-Family Homes Attached (duplex, triplex, condo, townhome)
__________du
__
Multi-Family Apartments (4 or more units/buildings)
__________du
__
Mobile/Manufactured Homes (lots & or acreage)
__________du
__
Recreational Homes (lots/sites & or acreage)
__________du
Non-Residential Uses (check all that apply)
__
Bank (with or without drive-through)
_______ sf
__
Church (all uses except classroom space)
_______ sf
__
Convenience store (with gas sales, or without gas)
_______ sf # of fueling positions/hoses ______
__
Hotel/Motel (# of rooms)
_______ rm
__
Office
_______ sf
__
Retail
_______ sf
__
Restaurant (sit down indoor &/or outdoor seating)
_______ sf
__
Restaurant (fast food with drive-through or without)
_______ sf
__
Warehouse
_______ sf
__
ACLF &/or Nursing Home
________ beds or rooms
__
Other _____________________________________
Size __________________________
Note: If project will be phased, or has multiple buildings, please give a breakdown showing the type and
number of units in each phase or building. Phase # / Building #
__________________________________________________________________________________________
__________________________________________________________________________________________
OFFICE USE ONLY
__
Fee of $175 in Cash or Check # _________ drawn to the order of Brevard County BOCC
__
Potable Water Certificate or Reservation Provider _____________________ Expires _________________
__
Sanitary Sewer Certificate or Reservation Provider _____________________ Expires ________________
__
Solid Waste Certificate or Reservation Provider _____________________ Expires _________________
__
1 Copy of Site Plan, Subdivision Plan or Concept Drawing with a General Statement
__
A finding of Non-Deficiency
of Way Use Permit with the Land Development Office prior to _______________________________________
__
APPROVED CONDITIONALLY
__
Exempt per _____________________________________________________________________________
__
A Finding of Deficiency
__
DEFERRED OR DENIED
Reviewed by ____________________________ Date ________________ Title __________________________
White: Office Original Yellow: Land Development Copy Pink: Applicant Copy
POTABLE WATER SERVICE
CAPACITY AVAILABILITY CERTIFICATE
This certificate is issued for the purpose of verifying that potable water service is available pursuant to Section
163.3202 (2) (g), Florida Statutes. However, this certificate in no way reserves capacity for the project or
property described below and is issued for conditional Site Plan, Subdivision, or building permit approval only.
I. Unit of Government or Entity Issuing Certificate _______________________________________________
II. Applicant/Owner Information
Owner Name ________________________________________________________________________
Address _____________________________________________________________________________
Home Phone # __________________________________ Work # _______________________________
Applicant Name ______________________________________________________________________
Address _____________________________________________________________________________
Home Phone # __________________________________ Work # _______________________________
III. Legal Description and Development Proposal
Township Range Section Subdivision# Block/Parcel Lot
Subdivision Name ________________________________________________________________
Site Acreage ____________________________ Zoning Classification _______________________
If Residential: Type of Residential ____________________Maximum Number of Dwelling Units _________
If Non-Residential: Specific Uses _________________________________ Square Footage ______________
IV. Availability of Potable Water Service
The Following potable water capacities are available as of the date of this application.
__________ # of units or equivalent non-residential units
__________ gallons/day @ 250 gallons/residential unit/day
Affected Facility __________________________________________________
__ As of the date of this evaluation sufficient capacity is available for the project described in Sections III & IV.
__ As of the date of this application, potable water capacities are not available.
_____________________________________ ____________________________ __________________
Signature and Title Jurisdiction Date
V. The subject property is in an area not served by public water supply system and will be utilizing a private
well. Location of said wells must be shown on site plan.
_____________________________________ ____________________________ __________________
Signature and Title Jurisdiction Date
POTABLE WATER SERVICE
CAPACITY RESERVATION CERTIFICATE
This certificate is issued for the purpose of verifying that potable water service is available pursuant to Section
163.3202 (2) (g), Florida Statutes and that potable water service capacity is reserved for a specific time for the
development of the property in Section III of this certificate.
I. Unit of Government or Entity Issuing Certificate _______________________________________________
II. Applicant/Owner Information
Owner Name ________________________________________________________________________
Address _____________________________________________________________________________
Home Phone # __________________________________ Work # _______________________________
Applicant Name ______________________________________________________________________
Address _____________________________________________________________________________
Home Phone # __________________________________ Work # _______________________________
III. Legal Description and Development Proposal
Township Range Section Subdivision# Block/Parcel Lot
Subdivision Name ________________________________________________________________
Site Acreage ____________________________ Zoning Classification _______________________
If Residential: Type of Residential _________________ Maximum Number of Dwelling Units ____________
If Non-Residential: Specific Uses _________________________________ Square Footage ______________
IV. Capacity Reservation for Potable Water Service
The Following potable water capacities are reserved for the period of time specified herein or until capacity
consumption begins. Failure to utilize the reserved capacity within the specified timeframe shall require a
new concurrency evaluation.
__________ # of units or equivalent non-residential units
__________ gallons/day @ 250 gallons/residential unit/day
Reservation Period Beginning _________________________ Ending _____________________________
Affected Facility ____________________________ Government Jurisdiction ___________________________
Capacity reservations for potable water service are hereby certified for use by the applicant for the specified
reservation period.
_____________________________________ ____________________________ __________________
Signature and Title Jurisdiction Date
V. The property is in an area not served by a public water supply system and will be utilizing a well.
_____________________________________ ____________________________ __________________
Signature and Title Jurisdiction Date
SANITARY SEWER SERVICE
CAPACITY AVAILABILITY CERTIFICATE
This certificate is issued for the purpose of verifying that sanitary sewer service is available pursuant to Section
163.3202 (2) (g), Florida Statutes. However, this certificate in no way reserves capacity for the project or
property described below and is issued for conditional Site Plan, Subdivision, or building permit approval only.
I. Unit of Government or Entity Issuing Certificate _______________________________________________
II. Applicant/Owner Information
Owner Name ________________________________________________________________________
Address _____________________________________________________________________________
Home Phone # __________________________________ Work # _______________________________
Applicant Name ______________________________________________________________________
Address _____________________________________________________________________________
Home Phone # __________________________________ Work # _______________________________
III. Legal Description and Development Proposal
Township Range Section Subdivision# Block/Parcel Lot
Subdivision Name ________________________________________________________________
Site Acreage ____________________________ Zoning Classification _______________________
If Residential: Type of Residential ____________________Maximum Number of Dwelling Units _________
If Non-Residential: Specific Uses _________________________________ Square Footage ______________
IV. Availability of Sanitary Sewer Service
The Following sanitary sewer capacities are available as of the date of this application.
__________ # of units or equivalent non-residential units
__________ gallons/day @ 250 gallons/residential unit/day
Affected Facility __________________________________________________
__ As of the date of this evaluation sufficient capacity is available for the project described in Sections III & IV.
__ As of the date of this application, sanitary sewer capacities are not available.
_____________________________________ ____________________________ __________________
Signature and Title Jurisdiction Date
V. The subject property is in an area not served by public sewer supply system and will be utilizing an on-
site sewage disposal/septic tank.
__ This site is or can be made suitable for the use of an on-site sewage disposal system.
__ This site is currently serviced by an on-site sewage disposal system, which is adequate to handle the
proposed new development described above.
_____________________________________ ____________________________ __________________
Signature and Title Jurisdiction Date
SANITARY SEWER SERVICE
CAPACITY RESERVATION CERTIFICATE
This certificate is issued for the purpose of verifying that sanitary sewer service is available pursuant to Section
163.3202 (2) (g), Florida Statutes and that sanitary sewer service capacity is reserved for a specific time for the
development of the property in Section III of this certificate.
I. Unit of Government or Entity Issuing Certificate _______________________________________________
II. Applicant/Owner Information
Owner Name ________________________________________________________________________
Address _____________________________________________________________________________
Home Phone # __________________________________ Work # _______________________________
Applicant Name ______________________________________________________________________
Address _____________________________________________________________________________
Home Phone # __________________________________ Work # _______________________________
III. Legal Description and Development Proposal
Township Range Section Subdivision# Block/Parcel Lot
Subdivision Name ________________________________________________________________
Site Acreage ____________________________ Zoning Classification _______________________
If Residential: Type of Residential _________________ Maximum Number of Dwelling Units ____________
If Non-Residential: Specific Uses _________________________________ Square Footage ______________
IV. Capacity Reservation for Sanitary Sewer Service
The Following sanitary sewer capacities are reserved for the period of time specified herein or until capacity
consumption begins. Failure to utilize the reserved capacity within the specified timeframe shall require a new
concurrency evaluation.
______ # of units or equivalent non-residential units ______ gallons/day @ 250 gallons/residential unit/day
Reservation Period Beginning ___________________________ Ending _______________________________
Affected Facility ____________________________ Government Jurisdiction ___________________________
Capacity reservations for sanitary sewer service are hereby certified for use by the applicant for the specified
reservation period.
_____________________________________ _______________________________ __________________
Signature and Title Jurisdiction Date
V. The subject property is in an area not served by public sewer supply system and will be utilizing an on-
site sewage disposal/septic tank.
__ This site is or can be made suitable for the use of an on-site sewage disposal system.
__ This site is currently serviced by an on-site sewage disposal system, which is adequate to handle the
proposed new development described above.
_____________________________________ _______________________________ __________________
Signature and Title Jurisdiction Date
SOLID WASTE
CAPACITY RESERVATION CERTIFICATE
This certificate is issued for the purpose of verifying that adequate solid waste capacity is available pursuant to
Section 163.3202(2)(g), Florida Statutes, and the solid waste capacity is reserved for a specific time for the
development of the property as described in Section III of this certificate.
I. Unit of Government or Entity Issuing Certificate: BREVARD COUNTY SOLID WASTE MANAGEMENT
II. Applicant/Owner Information
Owner Name ________________________________________________________________________
Address _____________________________________________________________________________
Home Phone # __________________________________ Work # _______________________________
Applicant Name ______________________________________________________________________
Address _____________________________________________________________________________
Home Phone # __________________________________ Work # _______________________________
III. Legal Description and Development Proposal
Township Range Section Subdivision# Block/Parcel Lot
Subdivision Name ________________________________________________________________
Site Acreage ____________________________ Zoning Classification _______________________
If Residential: Type of Residential ____________________Maximum Number of Dwelling Units _________
If Non-Residential: Specific Uses _________________________________ Square Footage ______________
IV. Capacity Reservation for Solid Waste
The following solid waste capacity is reserved for the period of time specified herein or until capacity
consumption begins. Failure to utilize the reserved capacity within the specified time frame shall require a
new concurrency evaluation.
_________ tons/year DEVELOPMENT ORDER ______________________________________________
Reservation Period: Beginning __________________________ Ending _____________________________
Affected Facility: BREVARD COUNTY LANDFILL
Governmental Jurisdiction: Brevard County Solid Waste Management Department
2725 Judge Fran Jamieson Way
Viera, FL 32940
(321) 633.2042 FAX: (321) 633.2038
Capacity reservations for solid waste facilities are hereby, certified for use by the applicant for the
specified reservation period.
________________________________________________ _________________________
Signature and Title Date