APPLICATION
FOR TEMPORARY DWELLING PERMIT
Date__________________ Permit #_______________ Permit Fee $25.00 ___________
Property ID ___________________________________
Zoning_______________________________________
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Name and Street Address of Owner/Agent_______________________________________________
Street Address of Job Location
__________________________________________ Owner/Agent Telephone____________
___________________________________
Fax _____________________________
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Name and Street Address of Building Official
__________________________________________
___________________________________ Contractor
telephone_______________
___________________________________ Fax______________________________
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Front yard setback__________ Side yard setback__________ Back yard setback________
Notes/Conditions_____________________________________________________________________
It is understood that
a temporary dwelling permit allows for a temporary dwelling to be erected and inhabited
during construction of a permanent dwelling, when in compliance with Baroda
Township Zoning ordinance Section 10.09 A-E, on the same property description
for a period of ONE YEAR ONLY from date of approval of permit, by which time the
temporary dwelling must be removed.
______________________________________ _______________
Property Owner/ Agent Signature Date
_____________________________________________ __________________
Building Official Date
Please submit
site-plan with set-backs for location of temporary and permanent dwellings. Include
location of WATER supply and SEPTIC system.
Zoning Ordinance excerpts and grid sheet are provided.
Submit application to