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SUMNER COUNTY BOARD OF ZONING APPEALS
355 N. Belvedere Drive Room 202, Gallatin, Tennessee, 37066
OFFICE: (615) 451-6097 FAX: (615) 451-6074
VARIANCE REQUEST
Type of Variance: _____ Setback _____ Lot Size _____ Sign _____ Parking _____Administrative Appeal
Date Submitted:
Tax Map:
Group:
Parcel:
Acres:
Zoning:
Variance Address:
Property Owner:
Address:
City:
Zip Code:
Phone:
Email:
Applicant: (If different from property owner)
Address:
City:
Zip Code:
Phone:
Email:
Was a pre-application meeting held with staff? Yes No
Date of Meeting:
Purpose: Briefly describe the reason for this variance:
Signature of Owner or Owner’s Agent:
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Items required at time of application submittal:
1. ____ Application
2. ____ Application Fee of $75.00
3. ____ Warranty Deed
4. ____ Copy of the septic permit OR an affidavit of disclosure from the Environmental Dept. (Room 208)
5. ____ Obtain Public Notice Sign ($25 per road frontage, posted through meeting date returned to Room 202)
6. ____ Plot Plan containing all information listed below:
Show how many feet that any existing and/or proposed building(s) are located from all property line
boundaries, fences, and other structures located on the property.
Show setbacks and easements (if applicable) to the property.
Show the septic system.
Show the drain field (s)
Show existing or proposed landscape buffers, screening, fencing, entrance(s) from the county approved
road(s)
SIGN VARIANCE ONLY:
7. _____ Show the locations of signs (if any). A sign application is required with this request
PARKING VARIANCE ONLY:
8. _____ Show location of vehicle parking spaces AND indicate if your intentions are to request a variance for
“Dust Free Parking Surface” (You need to indicate this on your site plan)
9. _____ Show how many vehicle parking spaces including any handicap parking
10. _____ Specify if the vehicle spaces are to be used for customer parking or semi-temporary parking
Received by: ___________________ Date: __________________ Receipt #: __________________