Ohioville Borough / Beaver County, Pennsylvania

2

OHIOVILLE BOROUGH / BEAVER COUNTY, PENNSYLVANIA

APPLICATION FOR BUILDING PERMIT

(ORDINANCE NO. 8 ENACTED AND ORDAINED FEBRUARY 7,1963)

Permit No.

Date of Application: 4/1/2008 Home No. ()

Name of Property Owner: Work No. ()

Cell No. ()

Property Owners Address:

Location of Property: Parcel No

Name of Subdivision / Plan: Lot No.

Name of Contractor: Contractor’s

Address of Contractor: Phone No: ()

Total Size / Acreage of Tract Setbacks: Front Left Side

Size Yard: Front RSide Right Side Rear

LSide Rear

Drawing of Lot/Property: List neighbors on all sides, roads boarding property/lot, all buildings and or structures on lot. (include sheds ,swimming pools etc. approximate locations)

State all deed restrictions and covenants, if any, governing construction on the property to be built upon:

Type of Improvement or Construction: (must be submitted in detail) Residential / Commercial (Circle One)

IE: New Construction, Addition, Alteration/Improvement,

Type of Building: IE: Dwelling, Mobile Home, Modular Home, Garage, Pole Barn, Deck, Deck/Roof, Swimming Pool, Pool/Deck, Other

Having dimensions of: No.of stories

Decks only: inches above grade of deck floor

Pools only: Size Refer to Ordinance No. 123 for details.

List type of materials to be used: IE - Wood, Brick, Concrete Block, Vinyl Siding, Etc.

Estimated Cost of Construction/Improvement:

Estimated length of time for project

This Project Includes: Electrical ,Plumbing ,and or Mechanical

Must attach details of proposed work in writing and or diagrams.

Type of Water Supply: City, Drilled Well, Dug Well, Cistern, Spring

Type of Sewage Disposal System: Septic Tank, Sand Mound,City, Other

(If applicable) Has application / permit been made to install a Sanitary Sewage System? Yes No

If yes give Permit No

Property owner is responsible for submitting all plans and proposed work as requested when making application. Missing and or incomplete information may delay issuance of permit.

BUILDING PERMIT FEES ARE DUE AT THE TIME APPLI CATION IS MADE AND ARE

NON-REFUNDABLE

Thank you.

Date: ______Signature of Applicant: ______

Home Owner ______Other______

***********************************************************

Borough Use Only

Date application received:______

Is UCC inspection required: Yes______No ______

Affidavit ______and or Insurance Information on file______(check one)

Amount of Fees received: Borough______L&I______MDIA______

Date of Issuance of Permit:______

Permit No. ______

If permit is refused ,give reason:______

Borough of Ohioville

Signed: Person Issuing Permit______

Title ______

Revised 06 / 2005