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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