Fillable USE REQUEST FORM (Town of Cutler Bay)

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USE REQUEST FORM (Town of Cutler Bay)

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TOWN OF CUTLER BAY
Department of Community Development
Planning and Zoning Division
(305) 234-4193
Town of Cutler Bay | 10720 Caribbean Boulevard, Suite 105 | Cutler Bay, FL | www.cutlerbay-fl.gov
USE REQUEST FORM
Date: ________________
Requestor Name: _____________________________________________________________________
Requestor Mailing Address: _____________________________________________________________
_____________________________________________________________
Requestor E-mail Address: _____________________________________________________________
Requestor Telephone Number: __________________________________________________________
Property Information:
Address: ______________________________________________________________________
Folio No.: ______________________________________________________________________
Current Use: ___________________________________________________________________
Proposed Use: __________________________________________________________________
If this form is being requested to open a new business, please also complete the attached “Municipal Application for
Certificate of Use/Occupational License” for review by the Miami-Dade Department of Regulatory and Economic Resources.
Form may be submitted by mail, fax, or email.
Town of Cutler Bay
Attention: Community Development Department Fax: 305-234-4251
10720 Caribbean Boulevard, Suite 105 Email: planninginfo@cutlerbay-fl.gov
Cutler Bay, Florida 33189
Office Use Only
Current Zoning of Property: _______________________________________________________
Proposed Use Permitted: ______ YES ______ NO
Notes: ________________________________________________________________________
________________________________________________________________________
Staff Signature: _________________________________________________________________
Miami-Dade County Department of Regulatory and Economic Resources
MUNICIPAL APPLICATION FOR CERTIFICATE OF USE/OCCUPATIONAL LICENSE
*Section 1 & 2 must be completed prior to submittal for review accompanied with the municipal application along with
the payment of the initial review fee.Submittal of application may result in further reviews and additional fees incurred.
DATE
SECTION 1 – BUSINESS INFORMATION (to be completed by Applicant)
SITE/BUSINESS ADDRESS UNIT/SUITE# PROPERTY TAX FOLIO NUMBER
BUSINESS OWNER NAME BUSINESS NAME OR DBA
MAILING ADDRESS CITY STATE ZIP
CORPORATE OFFICER/PARTNER/AUTHORIZED REPRESENTATIVE (NAME & TITLE) TELEPHONE NUMBER E-MAIL
SQUARE FOOTAGE OF UNIT(S): PROPOSED USE/TYPE OF BUSINESS
Please note that a lease agreement may be requested to verify square
footage.)
Please note that some business types may require a DERM
Operating Permit. To determine if your business requires an
operating permit(s), please see page 2 of this application.
this application
Signature of applicant confirms the above information is true and correct. I understand the conditions under which my Certificate of Use (CU)
is being approved and accept that no changes or refunds can be made once issued.
PRINT NAME
SIGNATURE
SECTION 2 – MUNICIPAL INFORMATION (to be completed by Municipal Official or Staff)
MUNICIPAL CERTIFICATE OF USE APPLICATION NUMBER PREVIOUS USE/TYPE OF BUSINESS AT THIS LOCATION DATE OF LAST APPROVAL
Was a building permit required to establish/expand the current proposed use?
❑ YES
❑
NO
If Yes, provide the following:
MUNICIPAL BUILDING PERMIT NUMBER MIAMI-DADE COUNTY MUNICIPAL BUILDING APPROVAL NUMBER
MUNICIPAL OFFICIAL PRINT NAME TITLE
SIGNATURE TELEPHONE NUMBER
dermplanreview@miamidade.gov.
http://www.miamidade.gov/building
123_01-315 PAGE 1 8/20
Preliminary approval issued on Approved Use
Request Form, no Application Number issued.
Town of Cutler Bay Community Development
305-234-4262
TYPE OF BUSINESS / SPECIFIC USE REQUIRED OPERATING PERMIT(s)
Agricultural Packing Houses AW
Air Conditioning Repair AP (if coating or painting) and IW5
Aircraft Dismantling, Maintenance, Repair AP and IW or IW5 or IWP
Animal Grooming/Kennels IW5
Animal Hospital/Clinic IW5
Asphalt Plants
AP and IW or IW5
Automotive Repair IW5
Boat Manufacturing
AP and IW5
Boat Repair, Maintenance
AP and IW5 and MOP
Body Shops with Painting
AP and IW5
Carpentry Shop AP and IW5
Chemical Manufacturing
AP and IW or IW5 or IWP
Chemical or Medical laboratory
AP and IW5
Concrete Batch Plants
AP and IW5
Crematories (Human or Animal) AP
Doctors and Dentist with X-ray Developing
IW5 and One-Time Compliance Report for Dental Dischargers (40 CFR 441.50)
Dry Cleaners
AP (if using perchloroethylene “PERC”) and IW5
Food Processing Facilities
AP and GDO or IWP
Funeral Homes with Embalming AP (if cremations conducted on-site) and IW5
General – businesses that use, handle, store or generate hazardous materials
or hazardous waste
IW5
General – businesses inside welleld protection areas and served by septic tank systems IW6
General – businesses requiring handling, purchase or sale refrigerants containing
ozone-depleting compounds
APCF
General – businesses that use a potable water supply well PWO
General Construction Contractor IW5
Industrial Facilities
AP and IW or IW5 or IWP
Industrial/Commercial Laundry
IW or IW5 or IWP
Junkyards
AP and IW5
Machine Shop
AP and IW5
Marinas
AP and MOP
Metal Finisher
AP and IWP
Pharmaceutical Manufacturing
AP and IWP
Photographic Film Processing IW5
Plastics Manufacturing
AP and IW or IW5 or IWP
Powder Coating
AP and IW5 or IWP
Precious Metals Handling
AP and IW5
Print Shop
AP and IW5
Resource Recovery/Scrap Metal Facilities
AP and SW
Restaurants/Food Service Establishments GDO
Rock Mining Operations
AP (if crushing activities on-site) and IW5
Silk Screening
AP and IW5
Stone Cutting IW5
Tire Sales and Related Services IW5
Transmission Repair Shop IW5
Transporters of Liquid Wastes and Hazardous Materials LW
Operating Permit Abbreviation Key:
AP – Air Operating Permit GDO – Grease Discharge IW – Industrial Facility MOP – Marine Facility
APCF – Stratospheric Ozone Protection IW5 – Industrial Facility IWP- Industrial Waste Pretreatment PWO – Potable Water Supply
AW – Agricultural Waste IW6 – Welleld Protection LW – Liquid Waste Transporters SW – Solid Waste
Please note that if your business type is not listed below it may not exempt you from the requirement of obtaining an operating permit.
To obtain a copy of the specic operating permit application, please visit our website at http://www.miamidade.gov/permits/ or to verify if you require
an operating permit contact us at (786) 315-2800.
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USE REQUEST FORM (Town of Cutler Bay)

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Completed 22 January 2021

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