Application for ZONING PERMIT – NON-RESIDENTIAL ADDITION ...

Application for ZONING PERMIT – NON-RESIDENTIAL ADDITION
West Hanover Township, Dauphin County, Pennsylvania
(May require approved Land Development Plan)
Estimated Cost of Ordinance Ref: ____________ Zoning District: _______
Proposed Work: $_________
Parcel Number: ___________________
1. Address of Project: ______________________________________________________________
2. Name of Property Owner:_________________________________________________________
Address: ______________________________________________________________________
Home Phone Number: __________________
Business Phone Number:__________________
3. Name of Applicant: _____________________________________________________________
Address: ______________________________________________________________________
4. Name of Contractor: _____________________________________________________________
Address: ___________________________________________ Phone No. _________________
5. Lot width: ___________ft Addition use: _________________________________________
6. On-site Environmental Features: (check all that apply) Wetlands _____, Streams ______, Lakes &
(Show on site plan) Ponds _____, Floodplain _____, Steep Slopes (>25%) _____, None _____.
7. Utilities: Public water _____ Public sewer ______ Private well ______ On-lot septic ______
8. Size of Principal Structure: ______________ Height: _______
9. Size of addition: ________________ Height: ________ Total Impervious Coverage:_______%
10. Setbacks: Required –front yard _________ Actual –front yard _________
(Show on site plan) -left side yard ________ -left side yard ________
-right side yard _______
-right side yard _______
-rear yard ___________
-rear yard ___________
11. Parking spaces: Required _____________ by sq ft Provided ______________ spaces
(Show on site plan) _____________ by occupancy
12. Parking Entrance Distance from: property line _______ intersection _______ catchbasin _______
Sight distance: left ________ ft ±______% right ________ ft ±_______%
The undersigned is hereby applying for a zoning permit for a non-residential structure addition; said permit to be issued on the basis of
the information contained within this application. The applicant hereby certifies that all information and attachments to this application
are true and correct. The applicant is required to also submit a Site Plan showing actual dimensions and shape of the lot, exact sizes and
locations of existing buildings, with additions, and any environmental features on the lot. All other Ordinance requirements not
identified above also apply and shall be met. Appeals from granting or denying a permit may be appealed to the Zoning Hearing Board
through the normal application process. Section 195-184.C(1) states this permit is valid for 12 months from issuance.
____________________________ ____________________________ _____________
Applicant’s Signature Print name Date
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