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Application Fee: $25.00
Block: __________ Lot:__________ Qualifier:__________ Zone:__________
Work Site Address:
____________________________________________________________________________________
Applicant: ____________________________________ Phone: (_________) _______________________
Are you the Owner of the Property? Yes______ No______
Owner’s Address:______________________________________________________________________
Description of Work:
_____________________________________________________________________________________
Prior Variance(s): Yes______ No _____ Resolution #: __________________
Project Information:
Fence
o
Type:___________________________________________________________________o
Dimensions: L:__________ H:__________o
Is the fence enclosing a pool or replacing a fence around a pool? Yes______ No _____Pool
o
Above Ground_____ In Ground_____o
Dimensions: L:__________ W:__________ Depth:__________Shed
o
Prefab_____ Other:________________________________________________________o
Dimensions: L:__________ W:__________ H:__________*Height is from grade to peak.North Hanover Township
Zoning Permit Application
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Garage/Pole Building
o
Use:____________________________________________________________________o
Dimensions: L: __________ W:__________ H:__________ *Height is from grade to peak.New Home
o
Single Family_________ Multi-Family_________ Homestead _________o
Number of Bedrooms:_______________Addition
o
Use: ___________________________________________________________________o
Number of Bedrooms:_______________Other:_________________________________________________________________________
o
Use:____________________________________________________________________o
Dimensions: L: __________ W:__________ H:__________ *Height is from grade to peak.Use:
o
Proposed Use:____________________________________________________________o
Existing Use:_____________________________________________________________All permit application must be accompanied by a survey copy. The survey must show setbacks from
ALL property lines to the proposed structure. Distance must be in feet. Survey must show all structures on the property and their square footage.
Impervious Coverage
(prevents water from passing through i.e. all structures, sidewalks, paved driveways,pools, decks, concrete patios, pavers set in cement.)
Existing Lot Coverage_______sq.ft. + Proposed Lot Coverage _________sq.ft.= Total sq.ft________
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Total sq.ft_______________/Lot size:_____________sq.ft=_______________x100= ___________%
I hereby certify that I am the owner in fee of the above property or the agent of the owner with the owner’s authorization to make
application on his/her behalf for the proposed work. I certify that to the best of my knowledge the information I provided both on this
application and the supporting documentation are true and accurate. I also understand that I if my project disturbs 500 square feet or more
of land, I am subject to a Residential Lot Grading Plan Review as stated in Ordinance 2007-08. If the Zoning Officer determines a formal
grading plan need not be submitted, I, the applicant, fully understand that I am responsible to follow the rules, regulations and standards for
grading of residential lots in North Hanover Township in a manner which will promote the public health, safety, morals, and general welfare.
I understand that all applicable permits and approvals for zoning, construction and from other agencies must be obtained before the start of
work. I agree to comply with all zoning, land use, and safety requirements in effect.
Owner in fee:
Signature:__________________________________________ Print:______________________________________________ Date:__________
Instructions for Filing
Instructions
Please include a survey with your application.
Survey should include:
Location of all structures on the property
The square footage of all existing and proposed structures on the property
Location of well showing setbacks to proposed structure
Location of septic showing setback to proposed structure
Property boundary lines
Setback measurements (in feet) to all property lines for the proposed structure
As of October 14, 2005, any existing dwelling with well and septic which applies for a permit for an outside improvement must seek approval from the Burlington County Health
Department by calling 609-265-5548. Health Department approval for well and septic properties is required to ensure there are no encroachments and/or conflicts with the
well/septic systems.
$25.00 Application fee is due at time of application. All fees are non- refundable
Please allow 10 days for the application to be processed.
When Burlington County Board of Health approvals are needed, please send a survey showing the well, septic, current and proposed primary buildings and all accessory buildings on the
property, showing the distance from the well and septic. Please also include:
*****************************Office Use Only*****************************
Check/cash: ______________ Date received: _______________________
BOH Approval Received: _______________
Zoning Application: Approved___________ Denied__________
Yes_____No_____ : Lot Grading Plan Review Waived in accordance with Ordinance 2007-08
_____________________________ __________________
Zoning Officer Signature Date
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What the project is
Name
Physical address
Mailing address
Block and Lot
Contact information for the Burlington County Board of Health:
15 Pioneer Blvd, Westampton
PO Box 6000 Mt. Holly
Tel: 609-265-5548
Fax: 609-265-5541