Town of Poca Development Permit Application Structure OwnerName:Phone:Email: To whom should the permit be mailed? Property Owner Structure Owner Contractor Address: Street Address Address Line 2 City ZIP / Postal Code Property OwnerIf the address is the same as the structure owner, check YES. Yes If the address is the DIFFERENT from the structure owner, please fill out the Property Owner Address below.Name:Phone:Email: Address Street Address Address Line 2 City ZIP / Postal Code Previous Property Owner**If present owner has owned this property less than 4 years, provide the name of previous property owner.ContractorRequired for anyone performing contracting work, i.e., constructing a structure, installing a manufactured home, placing fill, grading, etc.Company Name:Phone:Email: Address: Street Address Address Line 2 City ZIP / Postal Code WV Contractor License Number:WV Manufactured Housing Board Number:NOTE: If installing a manufactured home, a WV Manufactured Housing Board License number is also required.Site InformationSite Address: Street Address Address Line 2 City ZIP / Postal Code Subdivision or Manufactured Home Park NameLot Number:Tax Map Number:Parcel Number:Lot Size:Directions to Site:Type of DevelopmentCheck and Complete All that ApplyType of Development Residential Addition for Residential Structure Accessory Commercial Addition for Commercial Structure Industrial Factory-Built Rental Community Please check and complete all that apply.Residential Type Single Family Single Family Duplex Multi-Family Manufactured Home Addition for Residential Structure Porch Room(s) Attached Garage Accessory Detached Garage Storage Building Fence Other Addition for Commercial Structure Construction costs are over 50% of the market value of the existing structure Construction costs are under 50% of the market value of the existing structure Type of AdditionAddition for Commercial StructureEstimated Construction Costs (Labor & Materials)Multi-Family, Commercial, Industrial, Factory-Built Rental Community DevelopmentPlease complete this section for Commercial, Industrial, Multi-Family, and/or Factory-Built Rental Community New ConstructionSelect a Construction Type Multi-Family Commercial Industrial Factory-Built Rental Community Multi-Family Townhouse Apartment Condominium Number of Dwelling UnitsCommercial: Number of Separate BusinessesCommercial: Type BusinessesIndustrial: Number of Separate BusinessesIndustrial: Type BusinessesFactory-Built Rental Community: Community NameWater / Sewer / SepticWater SourceName of Public Service District or Water CompanySewer SourceName of Public Service District of type Septic if it's a septic system.Notice If the Putnam County Planning Commission staff cannot determine if a proposed development is located in the floodplain, it shall require the applicant to have, at the applicant's expense, a certified engineer or surveyor determine if the proposed development is located in the floodplain. A certified engineer or surveyor shall use the Floodplain District Certification, and if located in a floodplain, the applicant shall be required to complete a FEMA Certification. This permit becomes null and void if work or construction authorized is not commenced within six (6) months or if construction or work is suspended or abandoned for a period of six ( 6) months at any time after work is started, unless extension is required. I hereby certify that I have read and examined this document and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. Granting of a permit does not presume to give authority to violate or cancel the provisions of any other federal, state, or local law regulating construction or the performance of coConsent(Required) I have read the above and agree.Fee Submission(Required) I UnderstandPlease send or deliver fees to the Office of Planning and Infrastructure, Putnam County Courthouse, 2nd floor, 12093 Winfield Road, Winfield, WV 25213. Office Hours: Monday-Friday 8 am - 4 pm. Make checks payable to "Putnam County Commission".Upload Required Documents: Drop files here or Select files Max. file size: 15 MB. NoticeNotice: I AgreeI hereby certify that I have read and examined this document and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. Granting of a permit does not presume to give authority to violate or cancel the provisions of any other federal, state, or local law regulating construction or the performance of construction.SignatureDate Check All That Apply: I am the applicant I am the business owner I am the property owner I am the contractor I am an agent If an Agent, for Whom: Δ
