BOA agenda 121018 - cancelled due to weather

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El ❑IMPROVEMENT PERMIT FOR AN INDIVIDUAL LOT(Up 10 600 GPD) S 310 PER SITE ❑IMPROVEMENT PERMIT FOR A SUBDIVISION 1 RECOMBINATION OF PROPERTY(Up m 600 GPD): NUMBER OF SITES IN SUBDIVISION 1 RECOMBINATION: S 310 PER SITE ❑SITE REVISIT TO REISSUE OR MODIFY A VALID IMPROVEMENT PM%4IT(Up to 600 GPD) S 100 PER SITE EACH SITE EYAL UA77ON CONSISTS OF UP TO 2 ACRER FLOWS OVER 600 GPD RE UIREADDITIONAL FEFfi CK:=mw THE FOLLOWING ARE REQUIRED BEFORE PROCESSING THIS APPLICATION FOR AN IMPROVEMENT PERMIT: O A SITE PLAN OR PLAT SHOWING THE EXISTING AND PROPOSED PROPERTY LINES Wl I DIMENSIONS AND TSE LOCATION OF ALL PROPOSED STRUCTURES,ADDITIONS,OR IMPROVEMENTS WITH LABELED SETBACKS. O EXISTING AND ANY PROPOSED PROPERTY LINES 1 CORNERS MUST BE CLEARLY MARKED ON SITE. O THE APPLICANT IS RESPONSIBLE FOR MAKING THE SITE ACCESSIBLE FOR THE EVALUATION. O FOR NON SINGLE-FAMILY DWELLING APPLICATIONS,ADDITIONAL INFORMATION TO DETERMINE WASTE FLOW AND CHARACTERISTICS WILL BE REQUIRED. AUTHORIZATION ❑AUTHORIZATION TO CONSTRUCT FOR NEW CONSTRUCTION S 160(Up to 600 GPD) ❑SITE REVISIT TO REISSUE OR MODIFY A VALID CONSTRUCTION AUTHORIZATION $100(Up to 600 GPD) THE FOLLOWING ARE REQUIRED BEFORE PROCESSING THIS APPLICATION FOR A CONSTRUCTION AUTHORIZATION: O A FLOOR PLAN OF THE STRUCTURE MUST BE SUBMITTED. O A SITE PLAN OR PLAT MUST BE PROVIDED SHOWING:THE LOCATION OF THE PROPOSED STRUCTURES, DRIVEWAYS,ADDITIONS,EXCAVATIONS OR OTHER IMPROVEMENTS;PROPERTY LINES;DIMENSIONS;AND SETBACKS TO REFERENCE POINTS. O THE EXISTING AND ANY PROPOSED PROPERTY LINES 1 CORNERS MUST BE CLEARLY MARKED ON SITE O THE LOCATION OF PROPOSED STRUCTURES AND IMPROVEMENTS MUST BE STAKED ON SITE. THE CONSTRUCTION AUTHORIZATION MUST BE ISSUED PRIOR TO ANY CONSTRUCTION. SUBSEQUENT CHANGES TO THE SITE PLAN FLOOR PLAN OR APPUCA770M WILL REQUIRE A NEW APPLICATION AND ADDITIONAL FEES. FLOWS OVER 6W GPD REQUIRE ADDITIONAL FEES. SIGNATURE SECTION ff © TOTAL AMOUNT DUE S RECEIPT# `" U ADDITIONAL FEES MAY BE REDUIRED IF THE RESULTING FLOW IS>6W GPD FOR NON-DOMESTIC WASTEWATER SYSTEMS, OR IF ADDITIONAL PERMITS ARE NECESSARY THIS APPLICATION MUST BE SIGNED BY THE CURRENT OWNER OF THE PROPERTY OR THE OWNER'S LEGAL REPRESENTATIVE(eg. SPOUSE,POWER OFATTORNEY,EXECUTOR, OR PERSON WHO HAS ENTERED INTO A CONTRACT OR LEASE 1MTH THE PROPERTY OWNER) ONLY ORIGINAL SIGNATURES CAN BE ACCEPTED. I AM THE PROPERTY OWNER OR THE PROPERTY OWNER'S LEGAL REPRESENTATIVE 1 HAVE READ THIS APPLICATION AND AUTHORIZE THE OCHD TO ENTER THE PROPERTYAND PERFORM THE SERVICE(S)REQUESTED. OWNER: DATE: l d 240