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i:at COUNTY, FL (Lake County Board of County Commissioners)

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U.S.A. forms for Lake County Board of County Commissioners

BROWSE LAKE COUNTY BOARD OF COUNTY COMMISSIONERS (FL) FORMS

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i:at
COUNTY,
FL
REAL
FLORIDA•
REAL CLOSE
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_________________________________________________________________________________________
Office of
Planning and Zoning
Variance Application
Date: __________________________
Owner's Name: ______________________________________________________________________________
Mailing Address: ____________________________________________________________________________
City ___________________________________________ State _____________ Zip Code ____________
Telephone Number: __________________ E-Mail Address:____________________________________________
Applicant's Name: ___________________________________________________________________________
Mailing Address: ___________________________________________________________________________
City _________________________________________ State ____________ Zip Code ____________
Telephone Number: _________________ E-Mail Address:____________________________________________
What is your variance request?: _________________________________________________________________
Site address: Alternate Key #______________________
Please attach or affix a copy of a warranty deed and tax receipt or current property record card describing the property
for which this variance is being applied.
What is the substantial hardship in meeting the specific code requirement? ________________________________
Describe how the purpose of the Land Development Regulation will be or has been achieved by other means:
Please attach any additional information you believe would assist staff in their research.
Office of Planning & Zoning Revised 2017/10
Variance Application Page 1 of 4
__________________________________________________________________________________
__________________________________________________________________________________
Variance Application
TO BE COMPLETED BY STAFF
BOA Application # ___________ Address Screen # ___________ Alternate Key#:
Section: Township: Range: Comm. District: _____ Size of Parcel: ______________
Existing Zoning: Future Land Use Designation:
Utility Area: Public Utilities:
Planning Area:
Has any application been filed within the last year in connection with this property? Yes ____ No ____
If yes, please explain briefly: _____________________________________________________________
Applicant is requesting a variance to the following sections of the Lake County Development Regulations:
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 MSA and/or at least 30% of
the dwellings in each phase are affordable; the project qualifies for expedited review.
Staff Planner Assigned: _____________________________ Fees Collected: ___________________
Office of Planning & Zoning Revised 2017/10
Variance Application Page 2 of 4
______________________________________
____________________________________
Variance Application
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 of the property legally described on page 1 of this application. AND
2. That he/she desires a Variance to the Land Development Regulations, as amended, as outlined on Pages 1 &
2 for the reasons as stated therein; AND
3. That he/she has appointed ________________________________________________ to act as agent in
his/her behalf to accomplish the above.
4. Permission is granted for staff to conduct a site visit for purposes of review of this variance application.
(Owner’s Signature)
State of Florida
County of Lake
Sworn to (or affirmed) and subscribed before me by means of □ physical presence or □ online notarization, this
day of , 2020, by
.
Personally Known OR Produced Identification
Type of Identification Produced _______________________________
Notary Signature
(SEAL)
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.
Office of Planning & Zoning Revised 2017/10
Variance Application Page 3 of 4
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__________________________________________________
____________________________________
Variance Application
APPLICANT’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 affirms and Certifies that he/she understands and will comply with all Ordinances, Regulations,
and Provisions of Lake County, Florida, and that all statements, drawings and diagrams submitted herewith are
true and accurate to the best of his/her 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.
(APPLICANT’S SIGNATURE)
State of Florida
County of Lake
Sworn to (or affirmed) and subscribed before me by means of □ physical presence or □ online notarization, this
day of , 2020, by
.
Personally Known OR Produced Identification
Type of Identification Produced _______________________________
Notary Signature
(SEAL)
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.
Office of Planning & Zoning Revised 2017/10
Variance Application Page 4 of 4
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i:at COUNTY, FL (Lake County Board of County Commissioners)

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Completed 18 July 2020

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