WAYNE TOWNSHIP BUILDING PERMIT APPLICATION ZONING

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WAYNE TOWNSHIP BUILDING PERMIT APPLICATION ZONING Permit No. Date Issued Name of Applicant Address Phone Name of Contractor Address Phone Name of Property Owner (if different) Address Phone 1. PURPOSEOF PERMIT: New Construction Addition Alteration Change of Use Sign(s) Fence Other(specify) Conditional Use 2.STRUCTUREUSE 3. LOCATION: House Number and Name Of Street Lot Number Property ID Number 4. PROPERTYSIZE: Width ft. Length ft. Lot Area sq.ft. 5. YARD DISTANCES: Front ft. Rear ft. Sides ft. And ft. 6. DIMENSIONS OF PROPOSED BUILDINGS: Width ft. Depth ft. Height ft. Area sq. ft. No. of Stories 7. INTENDED USE OF BUILDING: Residence Duplex Apartment Commercial (state type) Garage or Carport Number of Vehicles Other (specify) 8. ESTIMATED STARTING AND COMPLETION DATES: Starting Date Completion Date 9. COST OF NEW BUILDING OR IMPROVEMENT: Estimate $ 10. ZONING DISTRICT 11. FLOOD PLAIN YES NO MAP# I, the undersigned, do hereby certify that the above information and the accompanying plans and site are true and correct. Date Fee Paid $ Signature of Applicant Application and plans: approved disapproved Zoning District Signature of Officer

WAYNE TOWNSHIP PERMIT ATTACHMENTS SITE PLAN AND BUILDING PLAN MUST ACCOMPANY APPLICATION INDICATING: A. Length and width of Lot, name of abutting streets, and property owners. B. Distance from side, front and rear property lines to existing and proposed structures, additions, garages, porches, decks, swimming pools, sheds, etc. C. Dimensions of all existing and proposed structures, additions, porches, decks, pools, sheds, etc. D..Construction drawing OTHER INFORMATION REQUIRED: A. Contractors proof of workmen's compensation insurance B. Valid permit for connection to public sanitary sewer or on-lot sewage disposal permit. (If sewage facilities are proposed). C. Proof of property ownership or site control.

WAYNE TOWNSHIP BUILDING PERMIT INSTRUCTIONS LAND USE DEVELOPMENT APPLICATION 1. When application is completed, you must return the application to the Township Secretary at the Township Office along with payment. 2. The following will be required by the Officer: a. Completed application b. Drawing showing structure location, with all distances to property lines, right of ways, other buildings and etc. c. Information including name and proof of ownership of property, ID tax number (36- ) d. Proof of valid sanitary sewerage connection permit or on lot sewerage permit e. Costs: ($0.10) per square foot of floor space plus ten dollars ($10.00). f. driveway permit when necessary. 3. Permit Issuance: Will be made within five (5) working days of receipt of completed application. Permit will be issued or denied in writing to applicant. Area to be used for construction must be marked in some way 4. Final Site Inspection: Inspection when construction is completed. Township to be notified when construction is completed. The Officer shall conduct a final inspection within five (5) working days after notification of completion. Permits are required for: All construction (profit or non profit), trailers, sheds, farm buildings. swimming pools, etc., larger than 100 square feet. No permits are required for fences. All buildings may be taxable, even if smaller than 100 square feet, if assessed by the county tax assessor. This includes metal sheds and other out buildings.

Building Permit Application (Drawings or Specs required) Location of Proposed work or improvement County: Municipality Site Address, Tax Pa.r:cel# Owner Phone# Cell# Mailing Address Principal Conractor Phone# Fax# Cell# Mailing Address Arcrurect. Phone# Fax# Cell# Mailing Address, TYPE OF WORK OR IMPROVEMENT (Check all applicable) o New Building o Addition 0 Alteration CJ Relocation Cl Repair D Mechanical CJ Demolition CJ Electrical CJ Mobile Home 0 Change of Use [J Plumbing 0 Other CJ Foundation Only Describe the proposed work: Estimated Cost of Construction (Reasonable fair market value) $

Description of Building use (check one) Residential DOne Family Dwelling (R-3) Non-Residential Specific Use. (J Two Family Dwelling (R-3) Use Group Change in Use Yes No If Yes Indicate Fonner. Maximum Occupancy Load Maximum Live Load. Mobile Home Manufacturer..Model/Year Serial # Building/Site Characteristics Number of Residential Dwelling Units: Existing Proposed. Mechanical Indicate Type of Heating/Ventilating/Air Conditioning Water Service: (Check) 0 Public Cl Private Sewer Service (Check) 0 Public 0 Private Septic Permit# Does or will yow: building contain any of the following: Fireplace? Number Type of Fuel. Type Vent Elevator/Escalator/Lifts/Movingwalks (check) 6) Yes 0 No Sprinkler System 0 Yes D No Pressure Vessels 0 Yes 0 No Refrigeration System [J Yes [J No Building Dimensions Existing Building Area Proposed Building Area Total Building Area Flood Plain sq.ft. sq.ft. sq.ft. Number of stories ---- Height of Structure Above Gradeft. Area of Largest Floor sq.ft. Is the site located within an identified flood hazard area? DYes 0 No Will any portion of the flood hazard area be developed? (JYes [J No ON/ A Owner/ Agent shall verify that any proposed construction and/or development activity complies with the requirements of the National Flood Insurance

Building Plan Requirements for Residential Projects All New residential home drawings shall bear the stamp and signature of the design professional responsible for the design. Drawings should be drawn to scale and shall provide the necessary information to verify compliance with the building code. Two sets of construction drawings shall be submitted and shall include the following mformation: D Title Page Drawing: to include the contact information for all design professionals, owners, and owners agents. Description of square footage per floor, number of floors, type of construction to be utilized and design criteria utilized. D Site Plan Drawing: The construction documents submitted with the application for permit shall be accompanied by a site plan showing the size and location of new construction and existing structures on the site and distances from lot lines. In the case of demolition, the site plan shall show construction to be demolished and the location and size of existing structures and construction that are to remain on the site or plot. D Structural Drawings: To include footing construction detail, foundation construction details, framing construction detail, concrete construction detail, masonry construction detail, wood construction detail, steel construction detail, stair detail and chimney detail, as apply D Electrical Drawings: To include all lighting facilities, electrically operated equipment, and electrical circuits required fur all service equipment of the building or structure. D Mechanical Drawings: To include size and type of appliances, construction of flues and chimney system, ventilation air provided, fresh air make-up provided, location of all ducting and piping. Include manual J or system sizing information. D Plumbing Drawings: To include an plan view and a riser diagram of waste and water piping, pipe sizing, grade of piping, drainage fixture unit loads on stacks and drains, water distribution design criteria. D Foundation Drawings: To include all applicable dimensions including footing sizes with description of reinforcement (if applicable), layout and description of foundation drain system location of all slabs describing thickness of slab, base, reinforcement, vapor barrier and any slopes. D Floor Plans: To include location and sizes of all doors, windows, closets, shelving, decks, cabinets, plumbing fixtures wall and column sizes, thickness, and material. Location and type of insulation. To include the use of all areas and means of egress components. D Roof Framing Drawing: To include size, type, location, and anchoring of roof trusses. NOTE: For Pre-Engineered trusses, floor joists and beams, all cut sheets, bracing and installation instructions must be available at time of inspection. D Floor Framing Drawings: To include same as above, except for floor joists on each floor. Page I ofl

WAYNE TOWNSHIP PERMIT ATTACHMENTS SITE PLAN AND BUILDING PLAN MUST ACCOMPANY APPLICATION INDICATING: A. Length and width of Lot, name of abutting streets, and property owners. B. Distance from side, front and rear property lines to existing and proposed structures, additions, garages, porches, decks, swimming pools, sheds, etc. C. Dimensions of all existing and proposed structures, additions, porches, decks, pools, sheds, etc. D. Construction drawing OTHER INFORMATION REQUIRED: A. Contractors proof of workmen's compensation insurance B. Valid permit for connection to public sanitary sewer or on-lot sewage disposal permit. (If sewage facilities are proposed). C. Proof of property ownership or site control.

Program and the Pennsylvania Flood Plain Management Act (Act 166-1978)specifically Section 60.3. Lowest Floor Level Historic District Is the site located within a Historic District? DYes I:J No If construction is proposed within a Historic District, a certificate of appropriateness may be required by the Municipaltiy. The applicant certifies that all information on this application is correct and the work will be completed in accordance with the "approved": construction documents and PA Act 45 Uniform Construction Code and any additional approved building code requirements adopted by the Municipality. The property owner and applicant assumes the responsibility of locating all property lines, setback lines, easements, right-of-way, flood areas, etc. Issuance of a permit and approval of construction documents shall not be construed as authority to violate, cancel or set aside any provisions of the codes or ordinances of the Municipality or any other governing body. The applicant certifies he/ se understands all the applicable codes, ordinances and regulations. Application for a permit shall be made by the owner or lessee of the building or structure, or agent of either, or by the registered design professional employed in connection with the proposed work. I certify that the code administrator or the code administrator's authorized representative shall have the authority to enter areas covered by such permit at any reasonable hour to enforce the provisions of the code(s) applicable to such permit, Signature of Owner or Authorized Agent Print Name f Owner or Authorized Agent Address Date

APPENDIX E SMALL PROJECT SWM APPLICATION AND WORKSHEET Wayne Township Small Project Stormwater Management Application As required by Wayne Township's Act 167 Stormwater Management Ordnance', a Small Project Stormwater Management Plan is required whenever more than 2,500 square feet of impervious surface is proposers. Impervious surfaces are areas that prevent the infiltration of water into the ground and shall include, but not be limited to, roofs, patios, garages, storage sheds and similar structures, and any new streets or sidewalks. Table E-1 To Calculate Impervious Surfaces Please Complete This Table Surface Type Length X Width = Building (area per downspout) Driveway Parking Areas Patios/Walks Other Total Impervious Surface Area to be Managed (Sum of All Areas) Proposed Impervious Area If the Total Impervious Surface Area is LESS THAN 2,500 Square Feet, read, acknowledge, and sign below. If the Total Impervious Surface Area is GREATER THAN OR EQUAL TO 2,500 Square Feet, complete the remainder of the Application. Property Owner Acknowledges that submission of inaccurate information may result in a stop work order or permit revocation. Acknowledgement of such is by signature below. I declare that I am the owner or owner's legal representative. I further acknowledge that the information provided is accurate and Municipal employees are granted access to the above-described property for review and inspection as may be required. :Owner: (Print Name) Date: (Signature) 1 Wayne Township can require the applicant to provide supplemental and additional information beyond the Small Project SWM Application if there is a threat to property, health or safety. 2 Refer to Ordinance Section 501, Responsibilities for justification of this application

Directions to Site: For Township Use Only o Street Cut/Driveway o Cut and Fill o PennDOT Highway Occupancy o DEP Floodway or Floodplain o Sewer Connection o On-Lot Septic o Zoning o Other DApproved CJ Approved DN/a

Plans Review and Liability Disclaimer Richardson Inspection Services, LLC recommends that all projects be prepared by a design professional. The intent of the plans review process is to direct the applicant to the applicable code sections pertaining to their project to ensure that upon installation the project will conform to the Pa Uniform Construction Code "UCC". Richardson Inspection Services, LLC does not guarantee or assume any responsibility for the application of the information provided by the plans review process. It is the responsibility of the persons performing the work to ensure that all the provisions of the UCC that pertain to your project are met prior to calling for an inspection. Richardson Inspection Services, LLC has been hired as the Building Code Official by the municipality and only represents the municipality. Richardson Inspection Services, LLC does not represent the owner of the property and is not working for the owner of the property. Richardson Inspection Services, LLC (or any of its employees or subcontractors charged with the enforcement of this code), while acting for the municipality in good faith and without malice in the discharge of the duties required by the UCC or other pertinent law or ordinance, shall not thereby be rendered liable. Richardson Inspection Services, LLC is hereby relieved from liability for any damage accruing to persons, or property as a result of any act or by reason of an act or omission in the discharge of its official duties unless otherwise provided by law. I hereby certify as the owner that the proposed work is authorized. Applicant/Owner Signature Date