2. 

3. FLOODPLAIN PERMIT

7. Date
9. Owner
10. Phone Number
12. Address
14. Contractor
15. Phone Number
17. Address
19. Project Location
21. Project Description - Check all that apply

    1. Single Family Residential
    2. Multi-Family Residential
    3. Manufactured (Mobile) Home
    4. Non-Residential
    5. Accessory Structure

    1. New Construction
    2. Substantial Inprovement (>50%)
    3. Improvement (<50%)
    4. Rehabilitation
    5. Critical Facility

    1. Fill
    2. Utility Facility
    3. Roadway/Trail
    4. Bridge/Culvert
    5. Channelization
23. Project Description if not listed above
25. Class of Permit/Fee Schedule

    Floodplain Permit: Class I

    1. Fence, less than or equal to 200 feet in length...........................................$100
    2. Fence, greater than 200 feet in length......................................................$200
    3. Shed or Deck........................................................................................$100
    4. Detached Garage...................................................................................$200
    5. Addition to a habitable structure..............................................................$800
    6. Fill, less than or equal to 500 cubic yard...................................................$800
    7. Fill greater than 500 cubic yards..............................................................$2000
    8. Utility Facility.........................................................................................$200
    9. Roadway/Trail........................................................................................$800
    10. Bridge/Culvert.......................................................................................$1000
    11. All other structures-fee to be determined by estimating processing expense.....TBD
27. .

    Floodplain Permit: Class II

    1. Construction of a new habitable structure...................................................$1000
    2. Publication/Public/Public Notice Fee............................................................$120
29. Acknowledgement of Fees*

    1. I have read and understand and will comply with the requirements of this Floodplain Permit.
Leave This Blank:


31. 1. Receive an email copy of this form.
32. Email address

    This field is not part of the form submission.

33. Submit Submit and Print

* indicates a required field