Building Permit Application

Building Permit Application
When submitting plans and documents with drawings, they must be in PDF format and 1/4" Scale
Property Location*

CityStark CountyStark County ETZ (within 4 miles of city limits)
Type of Project*

CommercialResidential BuildingResidential Accessory StructureResidential DeckEmergency Repair
Construction Type*

New ConstructionAlterationsAdditionRepair Only
Construction Type*

New ConstructionAlterationsAdditionAccessory Structure
Is this an Interior Remodel?*
Is this getting connected to City Water/Sewer?*

YesNo
All New Construction applications must provide a copy of an address verification letter from Stark County Emergency Management(contact Jolyn Bliss at 701-456-7607). This does not apply to Accessory Structure or Deck permits.
Serving Alcohol?*

YesNo
Applicant Information
Is the Applicant:

OwnerContractorOther
Applicant Name*

First NameLast Name
Company
Primary Contact Phone *
Please enter a valid phone number.
Primary Contact Email*
example@example.com
Owner Information
Property Owner*

First NameLast Name
Property Owner Phone*
Please enter a valid phone number.
Property Owner Email*
example@example.com
Property Owner Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Business Owner Information
Business Owner Name*

First NameLast Name
Business Owner Phone #*
Please enter a valid phone number.
Business Owner Email*
example@example.com
Contractor Information
Contractor or Self Contracted?*

Using a ContractorBuilding it yourself
Contractor Name*
Contractor Name
Contractor Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Contractor Email*
example@example.com
Contractor License Number*
Contractor Phone #*
Please enter a valid phone number.

Are you using a Design Firm*

YesNo
Design Firm Name*
Design Firm Number*
Please enter a valid phone number.
Design Firm Email*
example@example.com
Design Firm Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Project Information
Project Title*
Project Title
Property Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Description of Work*
Desired Start Date*

MonthDayYear
Desired Start Date
Estimated Cost of Project*
Property Use*
If other please explain
Other *
If other was chosen please explain
Foundation Type*
Foundation Type*
Structure Type*
If other Please explain
Structure Type*
If other Please explain
Other *
If other was chosen please explain

Zoning District (Zoning map @www.dickinsongov.com)*
Proposed Landscaping Width*
Height of Building*
Total Square Footage of Building*
Driveway Width*
Easement Shown on Plans*
Easement Shown on Plans
Land Use for Property*
Sidewall Height*
Building Dimensions*
Roof Height*
Impervious Surface %*
Building Coverage %*
Number of Paved Parking Spaces*
New Expansion of Existing Structure*
Deck Dimensions*
Existing Zoning Approvals (i.e. SUP, Variance etc..)
Required Documents
Site Plan Guidelines
Site Plan- Please submit only Site Plan/Civil Plans here*

Commercial buildings must have a engineered signed Site Plan.
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Pictures of Site (prior to new construction)*

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Building Plans (must be 1/4 inch scale) - Please submit as a single file*

Plans must include the following: Floor Plans(all levels), elevations, wall sections, structural plans, footing and foundation details, and MEP's
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Flood Plain (all levels)*

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Floodplain resources can be found here

1. Go to fema website
2. Type in the address, if a new lot type in the coordinates of the lot.
3. Screen shot the map where the lot is located along with the key.
Landscape Plan*

Attach Landscape description as well
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Materials List (Deck and Accessory Structure only)*

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911 Address Letter

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Southwest District Health Unit*

Application for Sewage and Water Facilities
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Application For Sewage and Water Facilities
Guideline For New or Large Alterations
Once the application has been reviewed and processed we will contact you Building Permits must be picked up within 14 days of notification. Failure to pick up permit(s) will result in cancelation of the permit(s). Cancelation or failure to pay may result in the property being charged or assessed all applicable fees.
I hereby certify that I have read and examined this application and know the same to be true and correct. I hereby certify that I have been authorized by the owner to act as his agent in applying for and obtaining this permit. All provisions of laws and ordinances governing this type of work will be complied with, whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. I further apply for a Building Permit and acknowledge that the information above is complete and accurate and this application is not a permit and all work will be performed in accordance with the conditions of the permit, the approved plans and specifications, and the North Dakota State Building Code. I will also allow work to remain accessible and exposed for inspection purposes. Furthermore, I grant City Staff access onto the subject property.
Signature*

Clear
Date*

MonthDayYear
Date
Should be Empty:

	Subcontractor Name
Plumbing
Mechanical
Electrical
Concrete
Excavation

Building Permit Application

Applicant Information

Owner Information

Business Owner Information

Contractor Information

Project Information

Required Documents