Florence Township Zoning Permit Application Form
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1
2FLORENCE TOWNSHIP
Do Not Write in This Space
Received ___________ By ___________________________
ZONING PERMIT APPLICATION
Cash _________ Check # __________ Card ____________
Application # ______________ Control # _______________
Application Fees:
Approved _______ Denied _______
Residential/Owner Occupied:
$50.00
Reason for denial ___________________________________
Signature: ________________________________
Commercial:
$100.00
Block: ____________ Lot: ___________ Zone: ______________
Work Site Address: ____________________________________________________________________________
Applicant Name: __________________________________________ Telephone # (____)___________________
Property Owner: ___________________________________________ Telephone # (____)___________________
Owner Address: _______________________________________________________________________________
Number
Street
City
State
Zip
Description of Work: ___________________________________________________________________________
____________________________________________________________________________________________
Prior Variance(s)?: Yes ___ No___
Approval Date: ______________ File No: _________________________
STRUCTURES
Ground floor area: Existing structure__________ Proposed__________ Total____________
Height of proposed structure: _______________
Setbacks for proposed work: Front_____ Rear_____ Side #1_____ Side #2_____
Secondary Front_____ (Corner Lots)
FENCES
Fence: Type_________________
Height_______
Location_________________________
POOLS
Pools: Above ground____Inground____ Distance from property line Side_____ Rear______
Fence Height__________ Filter location____________________
LOT CHARACTERISTICS
Lot size:
Width________
Depth_______
Square Footage_______________
Percentage of impervious lot coverage (prevents water from passing through i.e. structures, sidewalks, driveway,
pool, decks, concrete patio, not pavers set in sand without cement).
Existing Lot Coverage______sq.ft + Proposed Lot Coverage_____sq.ft = Total_____sq.ft____%
I hereby certify that I am the owner in fee of the above property or the agent of the owner with the owner’s authorization to make application
on his/her behalf for the proposed work. I also agree to conform to all applicable Florence Township Codes related to this project. I certify
that to the best of my knowledge the information I provided on this application and supporting documentation are true and accurate. I also
understand that false or misleading information is cause to revoke the Zoning Permit in addition to any construction permits issued for this
proposed work.
Owner(s) in fee: Signature: ____________________________________________ Date:_____________
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