Plainfield Township

Floodplain Permit Application Permit # _____ Site/Contact Information Site Address: _____ Primary Contact Person (check one) Property Owner Name Address Phone Email Applicant Name Address Phone Email Contractor Name PA Contractor s # Address Phone Email Project Type New Construction Addition Renovation/Alteration Driveway Covered/Enclosed Porch Flood Damage Repair Pool/Hot Tub Mechanical/Electrical/Plumbing Other:_____ Deck/Patio Detached Garage/Shed/Pole Barn Total Cost of Improvements: $_____ Flood damage related costs (if applicable): $_____ Market Value of Property (if property suffered flood damage, use pre-damage market value) $_____ Brief Description of Project: _____ _____ Check each box below indicating that all of the following will be submitted with this application: Two (2) copies of site plan with floodplain location shown Two (2) complete sets of construction drawings Print Name of Applicant: _____ Signature of Applicant: _____ Date: - _____ Print Name of Owner: _____ Signature of Owner: _____Date:_____ Page 1 of 2 Please complete page 2 By signing this form, the owner also gives Plainfield Township officials permission to access the property for all necessary Township6292 Sullivan TrailNaza

plans that address compliance with all relevant provisions of the Plainfield Township Zoning Ordinance Flood Hazard Overlay District Regulations (Section 507, as amended). Area?

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  Ordinance, Zoning, Plainfield, Township, Plainfield township zoning ordinance, Plainfield township

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