Fillable GENERAL ZONING USE PERMIT (City of Winchester)

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GENERAL ZONING USE PERMIT (City of Winchester)

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  • 19 check-boxes
  • 40 other fields

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File type: PDF

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CERTIFICATE #: ZUP-_________
DATE SUBMITTED:_________
ZONING USE PERMIT
GENERAL
(Form continues on reverse side)
Rouss City Hall
15 North Cameron Street
Winchester, VA 22601
(540) 667-1815
TDD (540) 722-0782
APPLICANT INFORMATION AND PROPOSED USE DESCRIPTION:
APPLICANT NAME:
TELEPHONE:
EMAIL:
FAX:
ADDRESS OF
PROPOSED USE:
BUSINESS/ENTITY NAME:
TYPE OF USE:
PREVIOUS USE OF
BUILDING/TENANT SPACE:
PLEASE DESCRIBE IN
DETAIL THE SCOPE OF
THE PROPOSED
USE/ACTIVITY:
Will there be any of the following alterations, modifications or repairs to the property?
Interior or exterior
modifications (e.g. – new
interior walls, building
additions, demolitions)?
Yes No
If Yes, explain:
Installation or replacement
of plumbing and/or
mechanical equipment?
Yes No
If Yes, explain:
Installation or replacement
of electrical systems,
connections, fixtures, or
wiring?
Yes No
If Yes, explain:
Any other alterations not
covered above (signage, site
alterations, etc.)?
Yes No
If Yes, explain:
Please note that if your proposal includes a change of use from the previous use of the space, then a building permit,
trade permit, and/or change of use permit may be required to ensure compliance with the Virginia Uniform Statewide
Building Code (VUSBC). If the space presently does not conform to code requirements, then alterations to the structure
may be required prior to occupancy to ensure compliance with the VUSBC.
APPLICANT SIGNATURE REQUIRED
I, the undersigned, certify that I have the legal authority to file this application and will comply with Winchester City
Code and the Zoning Ordinance pertaining to the operation of the proposed business.
NOTE: Any deviations, changes or revisions to the operation of the intended use not indicated on this form may void the
zoning approval for this use. It is the responsibility of the applicant to notify the Winchester Zoning & Inspections Office
of any changes to the operation not noted on this form. The City of Winchester will not be held responsible for
inaccurate information provided by the permit applicant.
Signature:
Date:
Printed Name:
FOR OFFICE USE ONLY
Building Official Review:
Date:
The VUSBC use group classification for the proposed use is:
This proposal constitutes a change of use via the VUSBC?
Yes No
Are any building, trade or change of use permits required?
Yes No
Zoning Administrator or Designee:
Date:
Approved: Approved with Conditions: Denied:
SECTION TO BE COMPLETED BY ZONING ADMINISTRATOR:
By Right Use(s):
Yes No
Zoning District:
Conditional Use:
Yes No
Conditional Use Permit #:
Historic District:
Yes No
CE District:
Yes No
Nonconforming Use:
Yes No
Site Plan Required:
Yes No
Site Plan #:
Ordinance Section
Type of Proposed Use
Permitted Use
Ordinance Section(s):
Conditions of Approval:
✔
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GENERAL ZONING USE PERMIT (City of Winchester)

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Completed 22 March 2021

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