The issuance of a Permit is based upon the facts stated and representations made in this application. The permit may be revoked if the use and/structure for which it has been issued violates any applicable Penn Estates Governing documents, Township, County, State, or Federal law or regulation.

A Permit may also be revoked if it has been issued in error or if issuance was based upon misrepresentations or errors contained in the application or otherwise made by the applicant.

The applicant bears all responsibility for ensuring compliance with all applicable laws and regulations.

I hereby authorize the designated Association’s Official to investigate, inspect, and examine the property set forth herein, including land and structures, to determine compliance with the governing documents.

By signing the application, I certify that all facts set forth within the application and all accompanying documentation are true and correct and that I(we) agree to comply with all regulations.

If the applicant is someone other than the owner, authorization notarized by the legal owner designating that the applicant is acting as a representative on behalf of the owner must accompany this application.

1. Complete dimensioning, drawn-to-scale plot plan of the lot showing proposed work and/or existing structure and building setback lines.
2. The location of proposed structure(s) or improvements.
3. Please show the approximate location of tree(s) to be removed. Trees must be marked so they are identifiable upon the inspector’s visits

*In order to consider an application complete, please submit the following:

For homeowner:

☐Completed Permit Application
☐Fee Applicable
☐A copy of the approved permit from Stroud/Pocono Township where applicable
☐A copy of a plot plan (or a sketch) which includes the proposed location of the work to be performed; if the proposed location is close to the property lines, an as-built survey may be required
☐A complete narrative describing the planned work and the materials to be used
☐A copy of the homeowner’s insurance policy (declarations page)

For Contractor:
☐Certificate of the contractor’s liability insurance with PEPOA named as the Certificate Holder (if applicable)
☐A signed contract (for work over $500.00) signed by the homeowner and the contractor (if applicable)
☐A signed “Contractor’s Agreement” between contractor and PEPOA (if applicable)

 

CLICK HERE to download the Contractor's Agreement

Received by: _____________________________________________    Date: _______________________

☐ Application
☐ Copy of Township permit
☐ Plot Plan/Sketch
☐ Narrative
☐ Insurance
☐ Homeowner’s signature

Date of completed application: _________________________

Reviewed by: __________________________________________________________________________

☐ Approved

☐ Denied

Reason for denial: