CITY OF CHESAPEAKE OPEN SPACE AND AGRICULTURE PRESERVATION (OSAP) PROGRAM

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CITY OF CHESAPEAKE OPEN SPACE AND AGRICULTURE PRESERVATION (OSAP) PROGRAM APPLICATION FOR SALE OF DEVELOPMENT RIGHTS Instructions to Applicant: The following items must be submitted in connection with your application to sell development rights to the City. If any items are missing or incomplete, your application cannot be considered. If you have questions about any of the application items please contact the Planning Department at the number listed below. 1. Application Form. Type or print in dark ink. Please complete all items in their entirety. If additional space is needed, please attach a separate page. All owners of the property must sign the application. 2. Deeds. Copies of the deed under which you acquired the property must accompany the application. If you are combining more than one parcel in your application, deeds to all of the parcels must be included. 3. Deeds of Trust. If there are any deeds of trust (mortgages) on the property, they must be included with the application. 4. Survey or Plat. A survey or plat of the property outlining the area you wish to include in the application must be provided. You must also indicate the total acreage of that area. These items do not need to be exact, as the City will have a physical survey prepared, if agreement is reached on the sale of your development rights. This survey will show the exact area on which the Open Space or Agricultural Preservation Easement will be located and the exact acreage. If you do not have a survey or plat, you can contact the Planning Department at the number listed below for a copy of a tax map (Scale 1 :4,000 ). APPLICATION MATERIALS SHOULD BE SUBMITTED TO: Jennifer S. White, OSAP Administrator Chesapeake Planning Department PO Box 15225 Chesapeake, VA 23328 Phone: 382-6176 Fax: 382-8356 jswhite@cityofchesapeake.net

APPLICATION FOR SALE OF DEVELOPMENT RIGHTS Please complete all items. If additional space is needed, attach separate sheets. 1. Property Owner Information Property owner: Phone Number: Mailing Address: Property Owner: Phone Number: Mailing Address: NOTE: Please include ALL owners of the property. Use separate sheet if necessary. 2. Address of Land to be Included in Program: 3. Tax Map Parcel Number: 4. Do you have a representative (attorney, accountant, etc.) you wish to receive information on your behalf? If yes, please provide the following information: Name: Phone Number: Address:

5. Are there any other deeds of trust (mortgages) on the property? If yes, please provide the following: Holder (Bank, Mortgage Company or Individual): Address: NOTE: Submit copies of any deeds of trust with this application. 6. Are there any other liens on the property? If yes, please provide the following information: Lien Holder: Address: 7. Is the land subject to any legal proceeding (e.g., foreclosure, bankruptcy, potential forced sale, estate settlement sale)? If yes, please describe (attach separate sheet if necessary): 8. Does the land, or any part of it, have any other easements on it, other than utility or drainage easements? If yes, please describe: 9. Is the land, or any part of it, subject to, or part of an application for, a conditional use permit, conditional rezoning, PUD zoning, subdivision approval, site plan approval, variance or other action by the City Council, Planning Commission, the Board of Zoning Appeals, or other authorized City agent? If yes, please describe the nature of the use or development permitted or applied for:

10. Are there any other uses or activities of a non-agricultural nature upon the land (other than a dwelling for the owner or occupant resident of the property)? If yes, please describe: NOTE: Please show on the survey or plat the approximate location where such uses or activities are located: 11. Is any part of the land marsh or swamp? If yes, how many acres NOTE: For preservation of agricultural lands, marsh or swamp lands (i.e. Mixed Alluvial Land; Mucky Peat; Mucky Peat, shallow over loams; Mucky Peat, shallow over sands; and Tidal Marsh), as determined based on the most current U.S. Department of Agriculture soil survey, are not eligible for sale of development rights. 12. Describe any agricultural uses of the land, including crops, pasture, forest products and/or livestock: 13. Total Acreage Proposed for Sale of Development Rights: Cropland or Pasture: High-value cropland (e.g., vegetables, fruit): Nursery/Orchard: Woodland/Upland (excluding swamp): NOTE: Exact acreage will be determined by the survey to be performed by the City in the event agreement is reached on sale of development rights. 14. Number of livestock/poultry on land: Swine: Cattle: Horses: Sheep: Chickens: Turkeys: Other:

15. List all structures on the property: Structure: Approximate Dimensions: I/We hereby make application to the City of Chesapeake for the sale of development rights on the property listed in this application, pursuant to the Open Space and Agricultural Preservation Ordinance. I/We understand and acknowledge that I/we incur no obligation by the filing of this application, and that the City of Chesapeake incurs no obligation by its acceptance of this application. I/We hereby certify that, to the best of our knowledge, the information contained in this application and accompanying materials is true and correct. I/We agree that employees or agents of the City of Chesapeake may enter upon the property at reasonable times in order to obtain or verify information needed in order to evaluate this application, to determine the value of development rights, or to perform other related work. ALL OWNERS OF RECORD MUST SIGN AND DATE THIS APPLICATION. Print Name Print Name Print Name