Town of Brookeville, Maryland
Application for Building Permit
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version)
TOWN OF BROOKEVILLE
P.O. Box 67
Brookeville, MD 20833
Phone: (301) 570-4465
Fax: 301-570-0355
Application Instructions:
1.Plans and specifications (8 copies) shall be submitted with this application for any alteration affecting the exterior dimensions of existing structures or for the construction of any new structures. For any work that requires a Historic Work Area Permit (HAWP) from the National Capital Park and Planning Commission, a copy of the HAWP application must accompany this form. All of the documents will not be returned and will remain on file with the Town Clerk-Treasurer.
2.If you are building a fence or wall, please provide a diagram (8 copies) of the fence specifying the type of construction, height and location with respect to property lines.
3.A non-refundable fee of $25.00 shall be paid to the Town of Brookeville along with submission of this application for all items other than new buildings (including homes, garages and outbuildings) or additions to existing buildings. For all new buildings or additions, the permit fee is based on a rate of $.15 per gross square foot of the building (not including unfinished basements and unfinished attic space) with a $75 minimum filing fee.
4. Construction methods must conform to all Montgomery County codes and are subject to inspection by the County.
5. Set-backs from property lines will be in accordance with the Town of Brookevilleís Zoning Ordinance.
6. Applications must be submitted no later than 10 days prior to the Planning Commission meeting to be reviewed. If received in less than 10 days, the permit will not be reviewed until the following monthís meeting.
Applicant to fill out following section:
1. Property Owner's name: ______________________________________
Address: _______________________________________________
Telephone number: _________________
2. Applicant's name (if different than Property owner): ______________
Address: _______________________________________________
Telephone number: _________________
3. Type of Construction: (please check all that apply)
□ New Home
□ New structure other than Home (garage, outbuilding, etc)
□ Addition to existing structure
□ Demolition of existing structure
□ Tree Removal (greater than 6"
in diameter) |
□ Add, remove, or change to exterior building materials
□ Fence
□ Deck
□ Swimming Pool
□ Add, remove, or change architectural features |
□ Other: (please describe) ______________________________________ |
4. Will the construction require the placement of any obstruction or the taking up or excavation of parts of the sidewalk, curb and gutter, driveway apron or street?
□ Yes □ No
If yes, please describe:_______________________________________
_________________________________________________________
5. Will any construction work be performed outside the hours of 8:00am and 6:00pm Mon - Fri?
□ Yes □ No
If yes, please describe hours of operation and nature of work:____________________________________________________
_________________________________________________________
_________________________________________________________
6. Estimated cost of improvement: $_______________
7. Estimated date for work to commence: __________
8. Estimated completion date: _________
9. Architect Company Name (if applicable): __________________________
Contact Name: __________________________________________
Address: _______________________________________________
Telephone number: ________________
10. Contractor Company Name (if applicable): _____________________
Contact Name: __________________________________________
Address: ______________________________________________
Telephone number: ________________
11. Address of adjacent property owners (these must be provided):
1. __________________________ 2. ____________________________
3. __________________________ 4. ____________________________
12. Signature of owner or applicant: ________________ Date: _______
For Town use only below this line
Receipt of Application Fee (please attach copy of payment)
□ Yes Town Clerk-Treasurer: _____________________________________
Date: ______________
Planning Commission Approval:
□ No exception taken
□ Approved as noted
□ Rejected as noted
Notes:
___________________________________________________
___________________________________________________
___________________________________________________
___________________________________________________
___________________________________________________
Planning Commission Chairperson: _______________ Date: _____
Town Commissioner: _________________________ Date: _____
Revised: 02/03 |
