Zoning Permit Request
Applicant Name*
Applicant Address*
Applicant City, State, Zip*
Applicant Phone*
Applicant Email Address*
Lot Area
Current Use*
Proposed Use*
Is the lot a corner lot?
For Structures
Type of Building
Existing Floor Area (sq ft)
Proposed Floor Area (sq ft)
Number of dwelling units proposed
Number of stories
Height of structure (ft)
Water Service
Sewer Service
Area of land disturbance (Estimated total of all clearing, grading, excavating, transporting, and filling activities on the site, including proposed septic drainfield areas)*
RLD Name
RLD License #
RLD Phone Number
RLD Email Address
Driveway Exits On
For Use
Provide details about type of business, machinery and equipment involved, hours of operation, number of employees, storage, parking, etc.
PLEASE EMAIL PLAT OR AERIAL VIEW OF PROPERTY WITH PROPOSED LOCATION AND DISTANCES FROM ALL PROPERTY LINES TO dmbishop@countyofamherst.com, sgstinnett@countyofamherst.com, or jsbryant@countyofamherst.com.
**E-signature***
By typing my name in the **E-signature** box above, I hereby certify that the information and attachments provided are true and accurate to the best of my knowledge.
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