Permit application for City of Wyoming, Iowa

Applicant/Owner_____________________________________________ Date:_____________

I hereby request to __ build __ alter buildings or structures on the following described

(Legal description available at Jones Co. Courthouse)

Block and Lot of Tract Area_______________________________________________

Lot square footage ____________

Phone number _______________ Address: __________________________________

Use: __ Residential __ Commercial __ Other Estimated Value ____________

Foundation: __ Concrete __ Block __ Other __ No Basement __ Basement

If Flood Zone A attach DNR Floodplain Permit Flood Zone __________

Zoning _______ Building Sq. footage___________ Height______ No. of stories ______

Front Yard Footage__________ Side Yard Footage_________ Rear Yard Footage_____

Principal Use____________________________________________________________

Other Information or Remarks_______________________________________________

Sketch the front or street side, show street, location of the sewer and water lines. Show any existing buildings and proposed building to be erected. Put in all dimensions, lot size, new building size and distance of all buildings from the lot lines. This does not need to be drawn to scale. Give an accurate estimate of the cost and save having the application returned.

I certify that the above and attached information is true and accurate and that the construction and use will comply with the zoning ordinance in all respects.

Signed________________________________________________________________

(applicant)

Action: __ Approved __ Disapproved _____________

Date

__________________________________ _______________________________________

Zoning Officer                                                         Council Member (s)

Fee: _________ Date Paid __________ ______________________________________

City Clerk

VOID ONE YEAR AFTER ISSUANCE - PENALTY OF $100 PER DAY WILL BE ASSESSED IF PERMITS ARE NOT APPROVED PRIOR TO START OF CONSTRUCTION

FEES MUST BE PAID AT TIME OF APPLICATION - Water Permit Sewer Permit

THE CITY DOES NOT DETERMINE PROPERTY LINES