Project Name
St. Johns County Growth Management Department
e-mail
Property Owner(s)
Address
City State Zip Code
Applicant/Representative
Address
Zip CodeCity State
YesNo
Are there any owners not listed?
I understand that reasonable inspections of the subject property may be made as part of the application review process. I understand
that any material misrepresentations or errors contained in this application or supporting documents may void an approved
application, at the reasonable determination of the County considering the Land Development Code, Comprehensive Plan, and other
applicable regulations.
Date
Phone Number
e-mail
I HEREBY CERTIFY THAT ALL INFORMATION IS CORRECT:
Signature of owner or person authorized to represent this application:
Signed By
Printed or typed name(s)
Property Tax ID No
Property Location
Major Access Size of Property
Zoning Class
Future Land Use Designation
Overlay District (if applicable)
Water & Sewer Provider
Present Use of Property
Please list any applications currently under review or recently approved which may assist in the review of this application including
the name of the PUD/PRD:
Revised August 24, 2015
If yes please provide information on separate sheet.
Application for:
Project Description (use separate sheet if necessary)
Cleared Acres (if applicable)
No. of lots (if applicable)
Proposed Bldg. S.F.
Phone Number
Fax Number
Fax Number
