PW_Flood _Prone_Area_Permit

Alachua County Department of Public Works

5620 NW 120th Ln., Gainesville, FL 32653

Tel. 352.374.5249, Fax. 352.338.3224

Development Review & Emergency Response

Send questions to: tholmes@alachuacounty.us or Ilalwani@alachuacounty.us
ALACHUA COUNTY FLOOD PLAIN DEVELOPMENT PERMIT APPLICATION
Applicant Name
Address
City
State
Zip Code
Phone Number
phoneFormat: (000) 000-0000.
Owner Name
Address
City
State
Zip Code
Phone Number
phoneFormat: (000) 000-0000.
Property Description:
Section
Township
Range
Grant
Lot Block
Subdivision
Tax Parcel Number
Plat Book
Page
Date Recorded

MonthDayYear
Legal Description: (if required, attached separate sheet)
Type of Use Requested within Floodplain: (Check all that apply and attach drawings)
Structure: Residential
Proposed elevation of lowest habitable floor
Structure: Non-Residential
Specify Type: Storm Drainage Facility:
Utility Construction
Fill
Steam Crossing
Other
OFFICE USE ONLY
Application Number
Date received

MonthDayYear
Date Issued

MonthDayYear
100-year Floodplain Elevation
Source
10-year Floodplain Elevation(if available)
Source
YesNo
Elevation Certificate Required
ApprovedDisapprovedConditional Approval Per Plan (see attached conditions)
Date

MonthDayYear
Development Review Engineer
*Plats recorded prior to 1982 may not identify Flood Prone Areas.
General Information (By Applicant)

PUBLIC WORKS ADMINISTRATIVE REVIEW - Section 401.20 (d) 1., 2., 3. 4. of the Unified Land Development Code
Application Date

MonthDayYear
DRS Date

MonthDayYear
Applicant (If different from owner, attached letter of authorization - see Section 402.06 of ULDC)
Property Address
City
State
Zip
Phone
phoneFormat: (000) 000-0000.
Email if applicable
example@example.com
Tax Parcel Number
Zoning
Land Use
Acreage
Section
Township
Range
Grant
Legal Description of Parent Parcel
General Description of Proposed Activity (check one): Submit a site plan with the dimensions showing the proposed activity within the parcel, existing structures on the property, flood plains and wetlands, where appropriate. If none exist on property, please indicate by note on the site plan.
Flood hazard permit for new Single Family Dwelling, Mobile Home, and MH replacement
phoneFormat: (000) 000-0000.
Flood hazard permit for boat docks under 600 square feet
Minor modifications to stormwater facilities previously approved by DRC
Agriculture pond greater than 200 cubic yards and not impacting floodplain or regulated resource areas
Signature of Applicant:
Date

MonthDayYear
STAFF COMMENTS (For Office Use Only)
Development Review Staff Comments:
Public Works Staff Comments:
ApprovedDeniedApproved with conditions
Public Works Representative
Date

MonthDayYear
Should be Empty:

ALACHUA COUNTY FLOOD PLAIN DEVELOPMENT PERMIT APPLICATION

OFFICE USE ONLY

General Information (By Applicant)