A copy of the application for building and mobile home occupancy permit follows:
APPLICATION FOR BUILDING AND MOBILE HOME OCCUPANCY PERMIT Office of the Mayor Application No. Village Hall Date: - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - (DO NOT WRITE IN THIS SPACE- OFFICE USE ONLY) Date: Perm, Parcel Date: ( ) Permit Issued Fee Paid to Village Clerk: ( ) Permit Denied $ Date: ( ) Application Appealed If denied, cause of denial: - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - INSTRUCTIONS TO APPLICANT: All information required by the application must be completed and submitted herewith. Applicants are encouraged to visit the Village Hall for any assistance needed in completing this form. 1. Name of Owner(s): Address: Phone: 2. Applicant’s name: Phone: Address: 3. Property interest of applicant: (Contract purchaser, etc.) 4. Address of proposed construction or mobile home: 5. Legal Description: (Lot, block, and subdivision: attach metes and bounds description, if necessary.) Cost of Improvement $ Square feet of Improvement 6. Proposed construction (check one or more, as necessary): ( ) New Building Type: Brick/Frame No. Rooms ( ) Alterations or additions to existing buildings (explain): 7. Use of existing and proposed structures (if applicable): Existing Use: Proposed Use: |
8. Two copies of sketch plat (drawn to approximate scale) shall be attached, showing the following: (a) Dimensions and use of all buildings; (b) Dimensions of lot; (c) Distance of each building from lot lines; (d) Distance of principal building from principal buildings on adjacent lot(s); (e) Distance between accessory buildings and principal buildings; (f) Distance from lot line to center line of abutting street(s); (g) Location (with dimensions) of driveways and off-street parking spaces; (h) Location of all easements; (i) Location of all underground utilities, including septic tanks, tile fields, and wells. 9. Application is hereby made for an Occupancy Permit as required under the Village Code for the erection, moving or alteration and use of buildings and mobile homes. In making this application, the applicant represents all of the above statements and any attached maps and drawings to be a true description of the proposed new or altered uses and /or buildings. The applicant agrees that the permit applied for, if granted, is issued o the representations made herein and that any permit issued may be revoked without notice on any breach of representation or conditions. It is understood that any permit issued on this application will not grant right of privilege to erect any structure or to use any premises described for any purpose or in any manner prohibited by the Village Code, or by other ordinances, codes, or regulations of the Village. Applicant: Date: |
(Prior Code, § 23-3-20)