APPENDIX A: MOVING PERMIT APPLICATION FORM

TOWN OF MOUNT PLEASANT - MOVING PERMIT APPLICATION

OWNER

MAILING ADDRESS

PHONE NUMBER

PREVIOUS OWNER

MAILING ADDRESS

PHONE NUMBER

MOVING COMPANY

MAILING ADDRESS

PHONE NUMBER

MOVING COMPANY STATE PERMIT NO.

PRESENT ADDRESS OF BUILDING TO BE MOVED

LOT NO.

BLOCK NO.

SECTION

TAX MAP NO.

FLOOD ZONE

ZONING DISTRICT

PROPOSED LOCATION BUILDING IS TO BE MOVED TO IF WITHIN CITY LIMITS (PLEASE NOTE IF TO BE RELOCATED OUTSIDE CITY)

LOT NO.

BLOCK NO.

SECTION

TAX MAP NO.

FLOOD ZONE

ZONING DISTRICT

BUILDING USE

ORIGINAL COST OF BUILDING

CURRENT APPRAISED VALUE OF BUILDING

EXTREME DIMENSIONS

EXACT LENGTH

EXACT HEIGHT

EXACT WIDTH

APPROXIMATE MOVING DATE

APPROXIMATE MOVING TIME

DESCRIBE THE EXACT ROUTE TO BE TAKEN (USE BACK IF NECESSARY)

LIST ALTERATIONS AND REPAIRS REQUIRED TO BRING THE BUILDING INTO COMPLIANCE WITH ALL BUILDING CODES (USE BACK IF NECESSARY)

ATTACHMENTS (IF RELOCATED IN THE CITY)

_______ RECENT (WITHIN 6 MOS. OF APPLICATION) REGISTERED AND SEALED ENGINEER'S SITE PLAN ESTABLISHING: (1) LOCATION; (2) FRONT, REAR AND SIDE YARD SETBACKS; AND (3) FIRST FLOOR ELEVATIONS REFERENCED TO THE NGVD 1929 DATUM

_______ PHOTOGRAPHS OF ALL ELEVATIONS

_______ BUILDING PLANS (to bring structure up to present building code, including foundation)

_______ INSURANCE DOCUMENTATION (as required in Sections 75.03, 75.04 and 75.05)

APPROVAL FROM POLICE DEPARTMENT     _______ APPROVED     _______ NOT APPROVED       __________________________________________________ SIGNATURE