Building Permit Application

When submitting plans and documents with drawings, they must be in PDF format and 1/4" Scale

Property Location*

City (in city limits)ETZ (within 4 miles of city limits)Stark County (outside ETZ and city limits)

Type of Project*

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

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

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 Name*

First NameLast Name

Business Owner Phone #*

Please enter a valid phone number.

Business Owner Email*

example@example.com

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.

Subcontractors If Applicable

	Subcontractor Name
Plumbing
Mechanical
Electrical
Concrete (footing, foundation, etc.)
Right-Of-Way Concrete (sidewalks, etc.)
Excavation
Water & Sewer

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 Title*

Project Title

Property Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Parcel Number*

Legal/Land Description*

Description of Work*

Desired Start Date*

Desired Start Date

Estimated Cost of Project*

Property Use*

If other please explain

Other *

If other was chosen please explain

Foundation Type*

Structure Type*

If other Please explain

Structure Type*

If other Please explain

Other *

If other was chosen please explain

Setbacks*

	North	South	East	West
Actual Setbacks

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..)

Site Plan Guidelines

Site Plan- Please submit only Site Plan/Civil Plans here*

Site Plans must show easements and follow landscape requirements.

Pictures of Site (prior to new construction)*

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

Flood Plain (all levels)*

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

Materials List (Deck and Accessory Structure only)*

911 Address Letter

Southwest District Health Unit*

Application for Sewage and Water Facilities

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*

Date*

Date

Building Permit Application

Applicant Information

Owner Information

Business Owner Information

Contractor Information

Project Information

Required Documents