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<br />CENTERVILLE <br />ZONING PERMIT APPLICATION <br /> <br />Identifvine Information <br /> <br />Name: <br /> <br />Address: <br /> <br />Job Site Address (if different): <br /> <br />City: <br /> <br />City: <br /> <br />State: <br /> <br />State: <br /> <br />Zip: <br /> <br />Zip: <br /> <br />Phone: <br /> <br />Construction Information <br /> <br />Contractor Name: <br /> <br />Address: <br /> <br />City: <br /> <br />State: <br /> <br />Zip: <br /> <br />Phone: <br /> <br />Fax: <br /> <br />Present Zoning: <br /> <br />Proposed Zoning: <br /> <br />Present Development: <br /> <br />Proposed Development: <br /> <br />Centerville requires the submittal of a certified land survey aod site plao(s} for all development pr~ects in the City. The <br />site plan(s} must be obtained before a building permit is issued. <br /> <br />I UNDERSTAND AND HEREBY AGREE THAT TIlE WORK FOR WHICH TIlE PERMIT IS ISSUED SHALL BE <br />PERFORMED ACCORDING TO TIlE FOLLOWING: (I) TIlE CONDITIONS OF THE PERMIT, (2) TIlE <br />APPROVED PLANS AND SPECIFICATIONS, (3) TIlE APPLICABLE CITY APPROVALS, ORDINANCES, AND <br />CODES, AND (4) THE STATE BUILDING CODE. I ALSO UNDERSTAND THAT I AM RESONSIBLE FOR <br />ENSURING THAT ALL REQUIRED INSPECTIONS ARE REQUESTED IN CONFRMANCE WITH TIlE STATE <br />BUILDING CODE. <br /> <br />x <br /> <br />Applicant's Signature <br /> <br />Please print Applicant's Name <br /> <br />Date <br />