2. Date of Request*
   Date of Request
4. Address of Request*
   Street Address, City, State, Zip Code
6. Property Owner/Tenant
8. Contact Name*
10. Address of Owner*
    Street Address, City, State, Zip Code
12. Telephone No.*
13. Fax No.
15. Email Address*
17. Statement

    1. All information is accurate to the best of my ability. By checking this box, you are agreeing to sign and take responsibility for the work on this permit.
21. NOTICE: REQUIREMENT FOR SURVEY/PLAT

    Pursuant to § 286-606.A. of the City Code, a zoning permit is required for the erection, construction, reconstruction, moving, adding to, or alteration of any structure, or the establishment of any land use. Effective immediately and pursuant to § 286-606.D. of the City Code, zoning permit applications for such work on single-family and duplex dwellings, including fence permits, and any work exempt from submitting a site plan for approval per City Code Section 286-326.46, is required to include the submission of a recent survey/plat drawn to scale identifying the following information: 

    1)  The property for which a permit is requested 

    2) The dimensions of the proposed improvement drawn to scale

    3) The distances between the proposed improvement to each property line and/or adjacent structure.

    Plats can be obtained at the Circuit Court Clerk's Office at 550 Boulevard from 8:00 am to 4:00 pm. Monday to Friday 

23. Site Acreage
25. Parcel Identification*
    Subdivision Lot & Parcel # and/or Tax Map Designation
27. Current Zoning*
29. Existing/Proposed Square Footage of Structure(s)*
31. Name of Subdivision
    (if applicable)
33. Proposed Land Use Activity
36. Consistency with Zoning
38. Existence of RPA/RMA*
    Please note whether lot of record delineates the Resource Protection Area (RPA) per the Chesapeake Bay Preservation Area requirements.
45. Type of Project

    1. New Construction
    2. Addition
    3. Deck (uncovered/covered)
    4. Porch (uncovered/covered)
    5. Garage/Carport
    6. Pool
    7. Shed
    8. Manufactured Building
    9. Ramp
47. Dimensions of Structure
49. Setback (front property line)
50. Setback (side property line)
51. Setback (rear property line)
53. Estimated Cost
57. Attachments

    1. Required $50 fee
    2. Site Plan for Construction
    3. Construction Document(s)
59. Site Plan for construction to include: details, dimensions, location of construction

    *please notate whether RPA/RMA exists on site

61. Construction Document
    May be submitted as a hard copy to the Building Official
63. Please email attachments to siteplans@colonialheightsva.gov to include with your submission if error occurs attaching files above.
Leave This Blank:


65. 1. Receive an email copy of this form.
66. Email address

    This field is not part of the form submission.

67. Submit

* indicates a required field