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Storm Water Certification Permit Form Fence

  1. Owner and Applicant Statement

    Statement Under penalty of intentional misrepresentation and/or perjury, I declare that I have examined and/or made this application and it is true and correct to the best of my knowledge and belief. I agree to construct said improvement in compliance with all provisions of the applicable ordinances. I realize that the information that I have affirmed hereon forms a basis for the issuance of the storm water management permit(s) herein applied for and approval of plans in connection therewith shall not be constructed to permit any construction upon said premises or use thereof in violation of any provision of any applicable ordinance or to excuse the owner or his successors in title form complying therewith. All parts of the permit submittal may be made available for inspection and copying pursuant to applicable sections of the Storm water and Floodplain Management Ordinance.

  2. Check if Owner Information Same as Applicant

  3. Buffers on Site

  4. Leave This Blank:

  5. This field is not part of the form submission.