single permit application form PERMITTEE INFORMATION Owner Name: Contractor Name: Address Address City, State, Zip City, State, Zip Phone #: Phone # Lot Address Workers’ Comp Certificate on File? Lot Number YES No PROJECT INFORMATION What would you like to do? (check all that apply) Build a new home Resurface Existing Driveway New Deck Addition/Remodel Existing Home Well, New Pool, New or Replace New Detached Garage Fence, New New Driveway Shed, New or Replace Additional Information we need: (fill in all that apply) Estimated Project Cost $ Exterior Dimensions of Shed X Square Footage Proposed: sq. ft. Dimensions of Deck X Number of New Bathrooms Dimensions of Pool X Number of New Bedrooms Dimension of Fence X X Type of Driveway Surface Sewer Type: Public Private Size of Driveway X Exterior Dimensions of garage X Written Description of Project (Required) A sketch of my lot, drawn to scale, and showing the location of the proposed improvements in relation to the property and street lines, right-of-way lines, and easements is attached (Required) SIGNATURE’S I certify that the above information is true and accurate. ___________________________________________________ Signature Date
single permit application form PERMITTEE INFORMATION Owner Name: Address City, State, Zip Phone #: Lot Address Lot Number Contractor Name: Address City, State, Zip Phone # Workers’ Comp Certificate on File? YES No PROJECT INFORMATION What would you like to do? (check all that apply) Build a new home Addition/Remodel Existing Home New Detached Garage New Driveway Resurface Existing Driveway Well, New Fence, New Shed, New or Replace New Deck Pool, New or Replace Additional Information we need: (fill in all that apply) Estimated Project Cost $ Square Footage Proposed: sq. ft. Number of New Bathrooms Number of New Bedrooms Type of Driveway Surface Size of Driveway X Exterior Dimensions of garage X Exterior Dimensions of Shed X Dimensions of Deck X Dimensions of Pool X Dimension of Fence X X Sewer Type: Public Private Written Description of Project (Required) A sketch of my lot, drawn to scale, and showing the location of the proposed improvements in relation to the property and street lines, right-of-way lines, and easements is attached (Required) SIGNATURE’S I certify that the above information is true and accurate. ___________________________________________________ Signature Date
single%20application.docx