City of Oakwood

YARD DEBRIS PAD APPLICATION

30 Park Avenue Oakwood, OH 45419

(937) 297-2920 FAX: (937) 297-2940

zoning@oakwoodohio.gov

Permit Fee: $50.00

Cash or Check; Credit Card payments can be made via our website, www.oakwoodohio.gov ($1.95 fee).

PROJECT ADDRESS
OWNER NAME
ADDRESS
EMAIL
PHONE NO.
OCCUPANT (If Different)
PHONE NO.

If an owner or lessee of property intends to use a contractor to perform work requiring a permit, the permit application must be signed by the contractor.

PERSON/COMPANY TO PERFORM WORK
CONTACT PERSON
ADDRESS
EMAIL
PHONE NO.
DESCRIPTION OF PROJECT: (Use back page for plot plan or attach drawing)
ESTIMATED COST OF PROJECT:

Please Read Carefully: The applicant certifies as to the accuracy of the information provided herein and that the work will be done in accordance with all city ordinances.

IT IS INCUMBENT UPON THE APPLICANT TO OUTLINE ALL PROPOSED WORK. ADDITIONAL PERMITS MAY BE REQUIRED DEPENDING UPON THE SCOPE OF THE PROJECT. PERMITS MUST BE POSTED AT THE SITE SO AS TO BE EASILY SEEN FROM THE STREET. CONTRACTORS ARE RESPONSIBLE FOR DAILY REMOVAL OF ALL CONSTRUCTION-RELATED DEBRIS FROM THE PUBLIC STREET OR RIGHT-OF-WAY.

Property Owner Signature (NOT CONTRACTOR)
Print Name
Date
APPLICATION STATUS: (INTERNAL USE ONLY)

______ Meets R/W policy requirements

______ Requires Special Use Approval

Permit Number
Date of Permit
Expiration of Permit
Cost