P. O. Box 863 Appomattox, VA 24522
Phone: (434) 352-8183; Fax: (434) 352-4214
inspections@appomattoxcountyva.gov
Before a permit is issued, you may need to seek additional information from the Appomattox County Health Department for approval. A 911 address will not be assigned for Wells, Accessory Structures, Recreational Vehicles or Temporary Housing.
This portion of the form must be notarized. You may submit the form as is to Appomattox County and then stop by during business hours (8:00 a.m.-4:30 p.m. Monday-Friday) at 153 A Morton Lane Appomattox, VA to have it printed and notarized. You may also print the PDF version of this form and have it notarized then drop it by the County Administration building in the Drop Box or at the front desk during business Hours.
I hereby certify that I am the owner of record of the herein described property or that the work proposed has been authorized by the owner of record and that I have been authorized to make this application as a designated agent. I agree to conform to all applicable state and local regulations, rules and policies and such shall be deemed a condition entering into the exercise of this permit. In addition, if a permit is issued, I certify that the code official or his authorized representative shall have the authority to enter the area(s) described herein at any reasonable hour for the purpose of enforcing the provisions of the applicable code(s).