No:            

APPLICATION FOR ZONING PERMIT

TOWN OF EMMITSBURG

 

OWNERSHIP

  Privately owned                    Publicly owned

Date Applied:       

Zoning:       

Applicant:        

Address:       

Phone:       

Indented Use Other Than New Dwellings

     

Size:            ft.            x              ft.       

Liber                      Folio                    Map                       Parcel

                                                                                

Contractor:       

Address:       

Phone:       

Lot Dimensions:              % lot Coverage:       

Area:       

Width (Front)                 (Rear)       

Depth (L Side)                 (R Side)       

Principle Use          Yards

Accessory:         Yards

Front         ft.

Front         ft.

Water Supply/Sewage

  Individual                         Existing

  Community 

Right Side         ft.

Right Side         ft.

Left Side         ft.

Left Side         ft.

Rear         ft.

Rear         ft.

 

Number of Off-Street Parking Spaces:       

 

If Commercial, number of employees:       

Working time:               hours:       

Type of Improvement

Type of Use

Fee:

  New

  One Family

New Dwelling

$       

  Addition

  Two Family

Alteration

$       

  Alteration

  Three or More Family

Other

$       

  Repair

  Swimming Pool

 

  Demolition

  Garage

       

  Carport

       

  Other       

  Other     Size:            ft.            x              ft.       

Offcial use only: 

(comments)       

 

Inspected:       

Approved:    Yes    No

The applicant hereby certifies and agrees as follows:  (1) that he is authorized to make this application:  (2) that the information is correct:  (3) that he will comply with all regulations of Emmitsburg which are applicable hereto: (4) that he will perform no work on the above property not specifically decribed in this application.

 

Any change with out approval of the agencies shall sufficient grounds for the disapproval of a permit. 

 

Signed:       

Action Taken:

  Approved

  Denied

  Other

Date:       

Remarks:

Additional Permits Required:

  County Building Permit

  County Plumbing Permit

  County Electric Permit

  Other

Mailing Address:       

Zip Code:           Phone:       

     

Note:  This permit expires 1 year from date of approval.  This permit does not exclude the applicant from acquiring the other state and local permits necessary prior to starting construction.

Zoning Administrator: