Zoning Permit Application Form

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Municipality of Germantown
Application for Zoning Permit
75 North Walnut Street
Germantown, Ohio 45327
Phone (937) 855.7255
Fax (937) 855.3215
Date:________________
Property Address: ________________________________ Property ID Number:____________________
Property Owner:__________________________________ Phone Number:_______________________
Applicant (if other than property owner):_____________________________________________________
Applicant’s Address:___________________________________ Phone Number:___________________
Complete Description of Proposed Construction and /or Use:____________________________________
Provide a detailed diagram or plot plan showing all dimensions of the lot, location of existing buildings, and location
of proposed construction. Show distances existing buildings and proposed buildings are from all lot lines. A scaled
diagram may be required along with additional information as the Municipal Manager or designee deems necessary.
The property owner understands that the application, diagram and other information presented for the above
construction and/or use shall be located entirely upon the property location indicated above and further understands
that the property owner shall be liable for substantiating same. The property owner and/or applicant further
understands that a Certificate of Zoning Compliance is required before the commencement of any use or
occupation of any building. This permit will expire within one year of issuance if construction has not
commenced.
_________________________________
_________________________________
Signature of Property Owner
Signature of Applicant
************************************************************************************************************************
OFFICE USE ONLY
Zoning District: _____________________
Date Reviewed: ___________________
Lot in Floodplain: Yes ( ) No ( )
Approved ( ) Disapproved ( )
(If Yes, is used exempt?) Yes ( ) No ( )
Easement on Property: Yes ( ) No ( )
Permit No:________________________
(If Yes, does it affect application?) Yes ( ) No ( )
Zoning Fees:______________________
_________________________________________
Signature of Zoning Compliance Officer
*If applicable, reason application was denied:________________________________________________

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