Zoning Permit Application

1. Applicant Information
Name of Applicant*
First Last
Email*
Applicant's Address*
Street Address Address Line 2 City State ZIP Code
Applicant's Phone*
Applicant's Fax
Relationship between Applicant and Owner*
- Agreement of Sale
- Leasing/Lessee
- Not applicable
Please describe relationship between Applicant and Owner

2. Property Owner Information
Please enter contact information for the Property Owner below, if different than the Applicant
Name of Property Owner
First Last
Owner's Address
Street Address Address Line 2 City State ZIP Code

(If different from applicant)
Owner's Email
Owner's Phone
Owner's Fax

4. Plans & Certification
APPLICANT CERTIFIES THE ATTACHED FILES ARE ACCURATE AND DRAWN TO SCALE

1. Actual dimension and shape of lot to be built upon

2. Exact size and location of all buildings on the lot, if any, and the location and dimensions of proposed buildings, structures or alterations.

3. Existing and proposed uses, showing number of families, if any, that the building is designed to accommodate.

4. Provisions made for the treatment and disposal of sewage, industrial waste, water supply and storm drainage.

5. A certificate of approval from the Bucks County Board of Health regarding proposed on-site sewage disposal and/or water, if such is proposed.

6. Any other lawful information that may be required by the Zoning Officer.

One copy of the plans shall be returned to the applicant by the Zoning Officer after he/she shall have marked the copy approved or disapproved and attested to the same by affixing his/her signature. The second copy shall be similarly marked and shall be retained and filed by the Zoning Officer.

The Applicant hereby certifies that the statements and data contained herein and attached are true and complete.
Plan File Uploads*
Drop files here or

Max. file size: 105 MB, Max. files: 10.
REQUIRED. All files must be less than 100MB in size.
Applicant Signature*
First Middle Last
By submitting this form, I certify all data herein is true and complete.
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1. Applicant Information