APPLICATION FOR REVIEW (RETAINING WALL)

APPLICATION FOR REVIEW (RETAINING WALL)
I / We hereby apply for permission to * the use of a fence in accordance with the following information and as shown on the accompanying drawings.
Legal description (street address or similar description that will readily identify, and definitively locate the proposed (Retaining Wall)
Legal owner of property:*

First NameLast Name
Registered address of owner:*

Street Address

Street Address Line 2

City / Town / VillageDistrict

Postal / Zip Code
Size of lot:*
Retaining Wall construction type:
i. Foundation*
ii. Structural framework:*
Depth and Width of Foundation:*
Length of Retaining Wall (in Linear Feet):*
Height of Retaining Wall:
Right Side:
Left Side:
Rear:
Front:
Value (not cost) of Retaining Wall:*
Current use of Retaining Wall:*
Proposed use of land:*
Intended date of commencement:*

DayMonthYear
Date
Intended date of completion:*

DayMonthYear
Date
Distance from street intersection (if located at a corner):
Street(s) and infrastructure which may be affected during constriction:
Site clearance at intersection of street:
The Architect / Engineer / Technician of Record is
Address of Architect/Engineer/Technician of Record is:

Street Address

Street Address Line 2

City / Town / VillageDistrict

Postal / Zip Code
Name of permittee or his authorized agent:*

First NameLast Name
Address of permittee or his authorized agent:*

Street Address

Street Address Line 2

City / Town / VillageDistrict

Postal / Zip Code
Phone Number
Please enter a valid phone number.
Cell Number*
Please enter a valid phone number.
Fax Number
Email Address*
example@example.com
Signature of permittee or his authorized agent:

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OR Upload a Digital Signature

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Date*

DayMonthYear
Date
Notes:
1. Application fees are $150.00 as per fee schedule.
2. Permit fees is charged at $0.25 per linear feet as per fee schedule.
3. Plans, diagrams and other data shall be submitted in four (4) complete sets with each application for a permit. If the CBA has no objections;
  1. One set will be retained by the CBA;
  2. One set will be returned to the owner;
  3. One set will be returned to the architect/engineer; and
  4. One set is to be kept at all times at the construction site.
4. Architects and/or Engineers are required to stamp AND sign each page of the documents submitted.
5. Technicians are required to CLEARLY write their names, AND sign each page of the documents submitted.
Upload Documents*

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Proof of Payment*

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