Growth Permit Application Form printable pdf download

GROWTH PERMIT APPLICATION

1. NAME of Owner of Lot _________________________________ Phone # ______________________

2. ADDRESS of Owner:

Street__________________City__________________ State _______ Zip ____

3. LOT Description

A. Subdivision Name ______________________________ Lot Number ____ Tax Map ____ Lot # ____

Street Name _______________________ Lot Area, Square Feet _________

4. DATE OF DEED of ownership of lot: Day ______ Month ________ Year ______

A. Date of deed registry – York County Registry of Deeds Date______ Book ____ Page ___

5. PURPOSE -

Single Family ___ Duplex ____ Multi-family ____ Other ____

6. FALSE INFORMATION: Any person who knowingly provides false information on an application shall be

subject to the penalties provided by law and shall not be eligible to apply for a Growth Permit Application for

a period of one (1) year.

7. APPLICANT CERTIFICATION, SIGNATURE AND DATE

I certify that all of the above information given by me is true and correct to the best of my knowledge.

_____________________________________

______________________________

Signature of Applicant

Date

8. For an application to be complete the following must be attached;

1. Septic design (HHE-200 form, no more than 2 years old), and

2. Application Fee of $200.00.

3. Current deed or purchase and sales agreement.

4. Before a permit can be issued - Articles of incorporation, or other types of business documents may be

required as proof of compliance with Section 6.C.4.

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9. DATE APPROVED BY CODE ENFORCEMENT OFFICER

Date ________ Time______

____________________________________

Code Enforcement Officer

10. EXPIRATION DATE OF GROWTH PERMIT

A growth permit which has not been replaced with a building permit within ninety days of Growth Permit

Approval by the Code Enforcement Officer shall be considered expired and must be resubmitted for consideration.

Building Permit application must be submitted to the Code Enforcement Officer by:

Date ____________

11. FINAL ACTION

Building Permit Number __________Date Issued ________ ______________________________

CEO Signature

Growth Permit Application Form