Zoning Clearance Application(Bldg Permit)

mseales — Tue, 10 Jan 2006 10:10:45 -0700

The City of Lorimor, Iowa

Zoning Clearance Permit Application

Date: ___________________                                                  Permit No.:____________

Name of Owner/Applicant _________________________            Home Phone _____________

Address _______________________________________             Work Phone ______________

Name of Builder(if applicable)________________________________

Address _________________________________________________

Location of the Improvement:

Lot __________ Block __________________   Addition ______________________

Street Address ____________________________________

Type of Improvement _______________________________

Present Use of Property ______________________________

Use District __________    Intended Use ____________________     Size of Lot _____________

Dimensions of Building: Width ____________ Depth _____________   No. of Stories _________

Complete all that apply:         Basement __________________sq. ft.
                                    First Floor __________________sq. ft.
                                    Second Floor ______________ _sq. ft.
                                    Garage ____________________ sq. ft.
                                    Accessory Bldgs _____________ sq. ft.
                                    Other (specify) ______________ sq.ft.

Number of Rooms:_______________   Bedrooms ______________ Bathrooms _______________

Material: Exterior Wall ____________________   Interior Wall ____________________________

Foundation _____________________ Roof ____________________ Floor __________________

The structure will set back:    ____________ feet from front property line,
                                            ____________ feet and ____________ feet from side property lines,
                                            ____________ feet from the rear property line.

Date construction is to begin: _______________________
Date Construction is to be completed: _____________________

ATTACH A DIMENSIONAL PLAN OF THE LOT SHOWING THE PROPOSED WORK AND EXISTING STRUCTURES WITH THE SETBACKS AND DIMENSIONS OF THE STRUCTURE.

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THE CITY OF LORIMOR, IOWA

The small town community of Lorimor, Iowa U.S.A. - Permits

Zoning Clearance Application(Bldg Permit)