Fillable PARKLET APPLICATION I: Application Form (Port of Richmond)

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PARKLET APPLICATION I: Application Form (Port of Richmond)

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City of Richmond Parklets Application Form
Department of Planning & Development Review
900 East Broad Street, Room 511
Richmond, VA 23219
804-646-3409
DRAFT
PARKLET APPLICATION – I: Application Form
Applicant Information
Name and address of business or organization requesting the permit:
Name of applicant/contact information:
Phone #:_____________________ Email: ___________________________________________________________
Parklet Location Information
Street Proposed: _______________________ between __________________and __________________________
Address(es) of property immediately in front of proposed parklet (on same block face), as applicable:
_____________________________________________________________________________________________
Returning Parklet?
Yes No
If Yes, write your permit number below and indicate whether the parklet design has changed since
your last application:____________________________________________________________________________
_____________________________________________________________________________________________
Property Owner(s) of Business Proposing Parklet
Name of property owner immediately in front of proposed location (if dierent than proposed
Permittee named above): _____________________Phone #:___________________________________________
Email:_________________________________________________________________________________________
If dierent from above, name of property manager / business owner for property:__________________________
___________________________________ Phone # _____________Email_________________________________
Signatures
Application is hereby made thru Department of Planning & Development Review (PDR) to Department of Public Works (DPW)
for a revocable permit to install a parklet. Applicant acknowledges and agrees that applicant has read and understands the Parklet
Permit Special Conditions and agrees to be bound by the terms thereof upon receipt of a permit to install and operate a parklet.
Applicant
__________________________________ (Name)
__________________________________ (Signature) _________________ (Date)
The following individuals (as applicable) support this application:
Property owner (if dierent than applicant)
___________________________________ (Name)
___________________________________ (Signature) _________________ (Date)
Property manager / business owner for property at the requested location (if dierent than above)
___________________________________ (Name)
___________________________________ (Signature) _________________ (Date)
NOTE: Please attach the required items, application form, including a completed checklist and the application fee ($300). Upon approval of
the Parklet, a Work in Street and Alley Permit Application Package must be submitted with an appropiate fee. Checks should be made
payable to the “City of Richmond”
For Oce Use Only: Enter as an Encroachment
Parklet Plan #: Parklet Permit #: Date Issued:
For Oce Use Only
Parklet permit application fee:$300
Parklet total outdoor area:
Receipt #:
Applicants must schedule a pre-application conference with parklet program manager to make sure the proposed parklet meets the criteria
outlined for approval and other issues that may be involved prior to making application. When your parket proposal is ready to submit you will
pay an initial intake fee of $300.
PARKLET APPLICATION – II: Check List
Applications must include the following:
A site plan diagram (no larger than 11’ x 17’), to scale, showing the location and dimensions of the
parklet and other objects in the immediate area (same block). The map shall include (but not be
limited to):
The street number addresses of nearby buildings;
The direction of trac;
The presence and location of: vacant lots or buildings, driveways, fire hydrants, manholes,
stormwater inlets, bike parking, utilities (including, but not limited to tree grates, vault, covers,
manholes, junction boxes, signs, lights, and poles), street furniture (including but not limited
to bus shelters, honor boxes, and benches), cafe seating;
Existing parking regulations (including, but not limited to; handicap parking, loading zones
and metered parking);
The length of the applicant’s street frontage;
Elevation Plans and a rendering.
At least two photographs from dierent angles along the sidewalk/street where the pedestrian
enhancement is to be installed. Applicants are encouraged to include photographs of potential
location-related conflicts (proximity to other street utilities, street furniture, etc.) noted in the
detailed site plan diagram.
Project narrrative: this is a short project description (about 800 words) explaning your vision for the
parklets. Applicants are encouraged to emphasize:
Vision for the parklet;
How the immediate neighborhood will benefit from the parklet;
Ideas about how the community can participate in the creation and / or stewardship of the
parklet;
Ideas for activation and programming of the parklet;
If known, include information about who will design the parklet.
In addition to you project narrative; you may also submit design drawings, sketches, or other
documents. These optional supplemental materials may help clarify your parklet vision to the City.
Letter(s) of support from property owners abutting the parklet.
Application must be submitted in an electronic format (PDF). Submit applications as a single PDF.
Submit applications to:
Ms. Yessenia Revilla
Department of Planning & Development Review
900 East Broad Street, Room 511
Richmond, VA 23219
804-646-3409
Email: Yessenia.Revilla@richmond gov.com
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City of Richmond Parklets Application Form
Department of Planning & Development Review
900 East Broad Street, Room 511
Richmond, VA 23219
804-646-3409
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PARKLET APPLICATION I: Application Form (Port of Richmond)

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Completed 1 November 2020

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