Department of Planning and Community Services
Form 700 – Village District Residential Permit Application
Villages of Point Hope, Point Lay, Wainwright, Atqasuk, Nuiqsut, Anaktuvuk Pass, and Kaktovik
This application is required for permit applications in all North Slope Borough (NSB) Villages, except Barrow. In Barrow,
please use the Form 800 Barrow Residential Permit Application. For non-residential Village applications, use Form 750.
If you need any assistance filling out this application, please contact the NSB Department of Planning and Community
Services at 907-852-0320. NSB permitting staff will assist you through the permit application process.
PART 1 – APPLICANT & OWNER INFORMATION
New Permit No. ____________
Amendment to NSB Permit No. ______
Existing NSB Permit No. __________
Application Date: _____________
Proposed Start Date: ___________
Completion Date: ____________ Date Received at NSB: _______________
Applicant Name:
_________________________________________________________
Phone: ______________________________________
Applicant Address: _________________________________________________________
Cell:
______________________________________
__________________________________________________________________________
Email: ______________________________________
Property Ownership (Check all that apply)
Applicant is property owner.
Property has multiple owners. Owner listed above is not the sole owner.
(Attach NSB Form 1300 Property or Land Owner Consent to the application).
Property is owned by one person.
Applicant is completing application form on behalf of Property Owner(s).
(Attach NSB Form 1400 Letter of Authorization for Agent to the application.)
Property is privately owned/unrestricted.
Applicant is a renter or contractor and has permission from Property Owner(s).
(Attach NSB Form 1300 Property or Land Owner Consent to the application).
Property is a restricted Native Townsite.
Applicant is executor of the estate.
(Attach the court document showing your executor status to the application.)
PART 2 – PROPERTY INFORMATION (Lot Location, Dimensions, and Information on Existing Structures)
Street Address/GPS Location: ______________________________________________ Village: _________________________________
Lot: _____________ Block: _____________ Survey or Plat No: _______________ Is the property vacant? Yes
No
2
Lot Width: __________________________ Lot Depth: ________________________ Lot Area (ft
): ____________________________
Number of Existing Buildings or Structures (e.g., homes, garages, buildings): _______ Describe type and use in box below.
North Slope Borough
Form 700 Village District Residential Permit Application
Department of Planning and Community Services
January 2015 (Rev.0)
Land Management Regulation Division
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