Town of Akron

TOWN OF AKRON

PERMIT APPLICATION FOR

BUILDING, REMODELING, DEMOLISHING, OR MOVING

Property Owner Telephone No.

Property Address:

Type of Permit:

( ) Residential ( ) Commercial

( ) New Construction ( ) Remodeling or Addition

( ) Curb and Gutter; Sidewalk ( ) Fence

( ) Premove Inspection

Contractor: Plumber:

Architect: Electrician:

Describe the nature of work to be done:

Building Size: No. Stories:

Proposed Use:

Please attach a plot plan showing the placement of structure, the grades, elevations, sidewalks, curbs and gutters, along with any other pertinent information.

No applications pertaining to medical marijuana or medical marijuana centers, including building permits, shall be accepted by the Town of Akron during the moratorium period which ends January 5, 2011.

I hereby acknowledge that I have read this application and that the information given is correct. I agree to comply with Town and State laws regulating construction, and certify that this construction is not related to the production or dispensing of marijuana. This application is not a permit until approved and signed by the Building Inspector and fees are paid.

Owner or Agent: Date:

ITEM VALUATION FEE RECEIPT NO.

Building

Curb and Gutter;

Sidewalk

Premove

Misc.

Amount Due

PERMIT INFORMATION TO BE COMPLETED BY BUILDING INSPECTOR

Inspector

Job Address Zone

Lot Size X Area sq. ft.

Vacant Y or N Variance Y or N

Side Yards ' Left/ 'Right/ ' Front/ 'Back

Building ' X ' Height '

Type of Construction:

Footings: Size X Type

Foundation: Size Type

Special Site Recommendations:

Special Inspector Required: Y or N

Roof: Type Roofing

Insulation: Type

Street ' Wide Improved Y or N

Alley ' Wide

Floor Ht. Above Street Grade:

Curb and Gutter:

Remarks:

Plans Checked By: Date:

Remarks:

Water and Sewer: Water Tap Checked By

Sewer Tap Checked By

Remarks:

Application Approved By: Date:

Building Inspector