2. Property Address*
4. Owner Name*
6. email address
8. Phone Number
10. Address1
12. Address2
14. City
15. State
16. Zip
18. Contractor Name
20. Contractor Phone Number
22. Address1
24. Address2
26. City
27. State
28. Zip
30. Plans By
32. Address1
34. Address2
36. City
37. State
38. Zip
40. Proposed General Use*
    -- Select One --ResidentialCommercialIndustrial
41. Cost of Project*
45. Type of Improvement*

    1. New Building
    2. Addition
    3. Alteration
    4. Repair
    5. Replacement
    6. Change of Use
    7. Accessory Structure/Use
    8. Permanent Sign
    9. Temporary Sign
    10. Fence
    11. Deck
    12. In Ground Pool
    13. Above Ground Pool
47. Residential

    1. One Family
    2. Two Family
    3. Multi-Family
48. Describe Residential Dwelling and Project to Be Considered For Approval:
50. Number of Garage or Other Parking Spaces
52. Non-Residential

    1. Church/Religious
    2. School/Educational
    3. Public Structure / Utility / Park
    4. Private Non-Commercial Recreation
    5. Bed and Breakfast
    6. Day Care Center
    7. Hospital. Institution, Nursing Home
    8. Other
53. Describe Non-Residential Business and Project to Be Considered For Approval:
55. Commercial

    1. Professional Office
    2. Banks/Financial Institutions
    3. Billboard Advertising
    4. Restaurant
    5. Retail Sales
    6. Commercial Recreation
    7. Drive Thru
    8. Auto Related Service
    9. Motel/Hotel
    10. Veterinary Clinic / Kennel
    11. Building Material / Lumber Sales
    12. Other
56. Describe Commercial Business and Project to Be Considered For Approval:
58. Industrial

    1. Warehouse/Distribution
    2. Contractor Storage Yard
    3. Minor Assembling/Fabricating
    4. Manufacturing/Processing
    5. Bottling / Packaging
    6. Trucking/Motor Freight Terminal
    7. Other
59. Describe Industrial Business and Project to Be Considered For Approval:
61. The owner of this building and undersigned, do herby covenant and agree to comply with all laws of the State of Ohio and the Zoning Resolution of Springfield Township, pertaining to buildings, and to construct the proposed building or structure or make the proposed change or alteration in accordance with the plans and the specifications submitted herewith, and certify that the information and statements given on this application, drawings and specifications are the the best of their knowledge, true and correct.
63. Application By
64. Date
    Date
66. Phone Number
68. Address1
70. Address2
72. City
73. State
74. Zip
78. Do Not Type Below This Line
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82. 1. Receive an email copy of this form.
83. Email address

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84. Submit Submit and Print

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