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You have the option to request a Development (Lake County Board of County Commissioners)

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BROWSE LAKE COUNTY BOARD OF COUNTY COMMISSIONERS (FL) FORMS

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Office of
Planning and Zoning
Conditional Use Permit
Application and Submittal Guide
Office of Planning & Zoning
Conditional Use Permit
Revised 2018/12
Page 1 of 6
You have the option to request a Development Review Staff (DRS) meeting or written comments only. Please check
which one you would prefer:
_____DRS Meeting _____Written Comments Only
1. Project name:
2. Applicant:
Mailing address:
Email:
Telephone number: _____________________________
Status: Owner ______ Agent ______ Purchaser ______
3. Owner:
Mailing address:
Email:
Telephone number: ______________________________
4. Describe the proposed use of the property:
______________________________________________________________________________________
Describe the existing use of the property:
______________________________________________________________________________________
5. Location of property:
_____________________________________________________________________________________
Property legal description: Section _________ Township _________ Range ________
Alternate Key #(s)
6. Area of property: _______________ Sq. Ft. Acres: ____________________
7. Does property have central water & sewer? Yes ________ No ________ NOTE: Utility provider
documentation required. Who is the utility provider in this area:
Does the property have an individual well and septic? Yes ________ No ________
8. List existing structure(s) located on site and use(s).
_______________________________________________________________________________________
9. Affordable Housing Projects: Estimated value of structure(s) and land for each lot.
Structure(s): $____________ + Land $____________ = $_____________. If the combined value is equal to
or less than 80% of the median price of a home in the Orlando Metropolitan Statistical Area and/or at least
30% of the dwellings in each phase are affordable, the Project qualifies for expedited review.
10. Is this application being requested due to any Code Violation(s)? Specify the basis or reason(s) for this
request.
Conditional Use Permit-Application and Submittal Guide
Office of Planning & Zoning Revised 2018/12
Conditional Use Permit Page 2 of 6
11. Has any previous application been filed in connection with this property?
YES _______ NO________. If yes, give the application or ordinance number and briefly describe the
nature and outcome of the request.
12. If the project is to be developed in phases, give a brief description of how it will be phased or attach a legible
descriptive document.
13. Please attach a copy of the warranty deed and the tax receipt or current property record card describing the
property for which this Conditional Use Permit is being applied.
To be completed by Staff:
Date: ___________________ CUP-_________________ New: _____ Amendment: _____
Verbal Pre-submittal Project# _________________ Project #:________________ AR #:______________
Existing Zoning: Future Land Use Designation: _________________________
Commission District: Section: Township: Range: ________
Planning Area: Utility Service Area: _________________________________
Notes: ______________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
Staff Name: _____________________________________________ Date: ______________________
Conditional Use Permit-Application and Submittal Guide
Office of Planning & Zoning Revised 2018/12
Conditional Use Permit Page 3 of 6
OWNER'S AFFIDAVIT
STATE OF FLORIDA
COUNTY OF LAKE
BEFORE ME, the undersigned authority personally appeared ____________________________, who being
by me first duly sworn on oath, deposes and says:
1. That he/she is the fee-simple owner or corporate officer of the ownership entity of the property legally
described and attached to this application.
2. That he/she desires a Conditional Use Permit to accomplish the above desired request, as stated on
Page One of this Application.
3. That he/she has appointed ___________________________________ to act as Agent in their behalf
to accomplish the above.
4. Permission is granted for staff to conduct a site visit for purposes of review of this conditional use
plan or development plan.
_______________________________________
(Owner's Signature)
STATE OF FLORIDA
COUNTY OF LAKE
The foregoing instrument was acknowledged before me this day of , 20 ,
by , who is personally known to me or who has produced
as identification and who _______did or ______did not take an oath.
Notary Public (Signature)
(SEAL)
Print or type Notary Name
Commission (serial) Number
My Commission Expires:
NOTE:
All Applications shall be signed by the Owner(s) of the Property, or some person duly authorized by the Owner to sign.
The authority authorizing such person other than the Owner to sign MUST be attached.
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Conditional Use Permit-Application and Submittal Guide
Office of Planning & Zoning Revised 2018/12
Conditional Use Permit Page 4 of 6
APPLICANT'S AFFIDAVIT
STATE OF FLORIDA
COUNTY OF LAKE
BEFORE ME, the undersigned authority personally appeared ____________________________, who being
first duly sworn on oath, deposes and says:
1. That he/she Affirms and Certifies that he/she understands and will comply with all Ordinances, Regulations,
and Provisions of Lake County, and that all statements and diagrams submitted herewith and attached
hereto, are true and accurate to the best of their knowledge and belief, and further, that this application and
attachments shall become part of the Official Records of Lake County, Florida, and are Not Returnable.
2. That he/she desires a Conditional Use Permit for the use as proposed for the property legally described on
this Application.
3. That the submittal requirements for this Application, which are attached hereto, have been completed and
attached hereto as part of this Application.
4. That the sign cards that are posted by the Economic Growth Department, on or after the first-working day of
the following month, after submittal of this Application, will remain posted until the Public Hearing of the
Planning and Zoning Commission and the Board of County Commissioners. After final determination by the
Board of County Commissioners, the sign cards shall be removed and destroyed.
_______________________________________
(Applicant's Signature)
STATE OF FLORIDA
COUNTY OF LAKE
The foregoing instrument was acknowledged before me this day of , 20 ,
by , who is personally known to me or who has
produced as identification and who ______did or _____did not take
an oath.
Notary Public (Signature)
(SEAL)
Print or type Notary Name
Commission (serial) Number
My Commission Expires:
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Conditional Use Permit-Application and Submittal Guide
Office of Planning & Zoning Revised 2018/12
Conditional Use Permit Page 5 of 6
PROCEDURES
1. Upon receipt of a sufficient application, the Department of Economic Growth shall advertise the request for a
public hearing in accordance with the following:
a. PUBLICATION - At least ten (10) days in advance of the public hearing before the Planning and
Zoning Board (PZB), a notice shall be published in a newspaper of general circulation in the County.
Said notice shall state the date, time and place of public hearing and nature of the matter to be
considered at said hearing, for both the PZB and the Board of County Commissioners.
b. MAIL - The Office of Planning and Zoning shall mail notices to adjacent property owners of all real
property contiguous to and within 500 feet of the Applicant's property. Mailing of said notice shall
be considered notice.
c. POSTING OF NOTICE - After an application has been filed, the Office of Planning and Zoning shall
cause a sign or signs to be posted on the property concerned. The sign or signs shall be located in
the most conspicuous place to the passing public. In addition, signs shall be posted on the public
access roads and County Road(s) closest to the property concerned.
2. After submittal of the complete application and determination of sufficiency, the PZB shall hold a public hearing
to consider the request, and shall recommend approval or denial to the Board of County Commissioners. You
will be notified (by letter) of the hearing date and time.
3. The Board of County Commissioners shall hold a public hearing during the same month to consider
the recommendations of the PZB, at which time a final decision will be made. You will be notified (by letter)
of the hearing date and time.
APPLICATION FILING FEES
Conditional Use Permits: (select one from A thru C)
A. CUP for All Others (CUPC) $750.00 + $ 7.50 per acre (cap of $1,000)
B. Conditional Use Permit Amendment (CUPM) $400.00
Fire Review
Fire Review Fee (FDF) (Optional) $181.00
Health Department
Zoning/CUP Map Amendment (HDZMA) $ 75.00
All applications listed above are required to pay the Legal Advertising Fee and Notification Fee. You will receive a
bill for this fee.
Notification Fee (NFEE*) Total Properties x .34 cents = $
$0.34 cents will be charged for all real property contiguous to and within 500 feet of the perimeter of the Applicant’s property.
Staff will calculate this fee.
Capacity Encumbrance Letter Review (select one from A – B)
A. Capacity Encumbrance Letter - No Alternate Data – not submitting traffic study
Public Works – Stormwater: $ 30.00 (CELPWS)
Public Works – Transportation: $450.00 (CELPWT)
Growth Mgmt Administration – Parks, SW: $110.00 (CELADM) $ 590.00
B. Capacity Encumbrance Letter - Alternate Data – submitting traffic study
Public Works – Stormwater: $ 30.00 (CELPWSD)
Public Works – Transportation: $915.00 (CELPWTD)
Growth Mgmt Administration – Parks, SW: $110.00 (CELADM) $1055.00
Waiver – Central Water and/or Sewer Service – (WAV) $250.00
This fee will apply if the applicant is requesting a waiver.
Subtotal: $
A 1% service charge will apply if paying by credit card (of the total amount due) (CCARD) $ ____________
TOTAL: $
Public Hearing Applicant Initiated Postponement [ZFB] $100.00
Please note: Conditional Use Permit Applications may be subject to staff review prior to development. Please contact the
staff upon approval of the Conditional Use Permit by the Board of County Commissioners.
If the CUP is approved, you will be responsible for all fees associated with recording the ordinance into the public records
of Lake County. A staff member will contact you when the ordinance is complete and the total fees for recording the
document have been determined.
Make checks payable to: Lake County Board of County Commissioners
Conditional Use Permit-Application and Submittal Guide
Office of Planning & Zoning Revised 2018/12
Conditional Use Permit Page 6 of 6
SUBMITTAL GUIDE
The following required information shall be submitted when applying for a Conditional Use Permit.
____1. General Application Form.
A completed application shall be signed by all owners, or their agent, and notarized. Signatures by
agents will be accepted only with notarized proof of authorization by the owners.
____2. Copy of the Tax Receipt or Property Record Card and the latest recorded Warranty Deed showing
who the current fee-simple title holders of the property are. If the legal description shown on the
Warranty Deed is not correct or does not close you may be required to submit a Boundary Survey or
Sketch of Description of the property proposed for rezoning, certified by a professional land surveyor.
The legal description should appear on the face of the survey or description.
____3. A Boundary Survey or Sketch of Description is required of the property proposed for rezoning,
certified by a professional land surveyor. The legal description should appear on the face of the
survey or description.
____4. 11” x 17” plot plan, drawn to an appropriate scale, showing the following information.
____ a. Project name.
____ b. North arrow, date and scale.
____ c.Name, address and telephone number of the owner and applicant.
____ d. Property lines and contiguous street(s).
____ e. Location and dimensions of all existing and proposed structures, indicating their intended
use and setback distances from all property lines and roadways.
____ f. Existing and proposed means of vehicular ingress and egress to the property.
____ g. Location of off-street parking and loading areas, showing the number of spaces, and the
dimensions of access aisles and driveways.
____ h. Location of all buffers, screens, walls and fences, indicating their height and type of
materials used.
_____5. Utility availability and or no availability letter for central water and or sewer
_____6. Application for Capacity Encumbrance Letter (optional)
_____7. Any other information deemed necessary to establish compliance with this and other ordinances.
_____8. Application Fees
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Completed 6 August 2020

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