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 Home Permit App.
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 Name of Applicant or Owner:_________________________________________________



Date of Application:_________________  

Name of Subdivision or location of property (911 Address):________________________________________

Lot number: _________  Block: _____________  Section:______________

Name of General Building Contractor:__________________________________________

Address of Contractor:_____________________________________________________

Phone: __________________________________________


                                                           BUILDING INFORMATION:

Attach floor plan or scaled drawing (Required)

Type of Building:   Brick ____  Rock/Stone ____    Frame _____   Metal____

Foundation:   Slab _____   Pier/Beam _____

Lot Size: ____________  (Required-Attach Drawing)

Where will building be erected in relation to Lot Boundaries.

Front set back in feet _______  Right side _____  Left side _____   Back of lot  ______

( set backs to be filled in with number of feet--REQUIRED)

Does the building comply with the subdivision restrictions? (If not in a subdivision omit) __yes  __no

Use of Building? ____________________________ 

Estimated/Actual Cost_____________________

Estimated start of Construction:___________ 

Estimated Completion Date:___________

________________________________                             _________
Signature of Owner                                                          Date


_________________________________                            _________
Signature of Applicant if made by Contractor                      Date


Fee:___$75.00__plus a $25.00 Administration fee

Paid by:  Cash ______        Check No.___________   Money Order #___________

Application fee is separate and is due before the application can be submitted to the Council for review.

Permit Issued Date: ______________ Permit No. __________________


Site Built Permit Application.wps

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