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Step One

Property Address:*
Name*
Email Address
Phone Number*
Cell Number
After-hours Phone Number
Project Description:*
Check below if the construction will require the demolition of over fifty (50) percent of any existing structure.*
1. Yes
1. No
Primary Contact for Project:*
1. Resident
1. Architect
1. Project Manager
1. Contractor*
*MHIC/MD Contractor's License No.
Information for Primary Contact for Project (if different from property owner):
Name
Email Address
Work Telephone
Cell Number
After-hours Telephone
Is adequate on-site parking available for the construction crews?*
1. Yes
1. No
If no, please attach a parking plan which minimizes inconvenience to neighboring residents, and indicate if the property is in a permit parking area.
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Will road closing be required due to deliveries, equipment or other reasons?*
1. Yes
1. No
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Step Two

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Step Three

Building Permit Filing Requirements:
Application will not be reviewed until application is complete.
1. This application form, signed by resident.
2. Boundary Survey
3. Site Plan (see: Village Site Plan Checklist to ensure completeness)
4. Building plans and specifications
5. Tree Preservation Plan requested of Village arborist (see: Village Tree Inspection Request form). All required tree protections must be fully installed before any work begins.
6. Filing Fee (due at time of application). Fees schedule is listed in Chapter 6 of the Village Code.
7. Damage deposit or performance bond (due when Building Permit is issued). Amount of required deposit or bond will be set by Village Manager.
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Once this permit application is complete, the Village Building Officer and Village Manager will review the application and accompanying documents and, under most circumstances, act on the application within 5 to 10 working days.
No signs advertising the architect, contractor, or any other service provider may be posted on the work site.
I hereby certify that I have the authority to make the foregoing application, that the application is correct, that I have read and understood all requirements and that the construction will conform to the regulations of the Montgomery County Zoning Code, the Village Code including Urban Forest code, and any covenants and easements on the subject property.
Electronic Signature Agreement
By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.
1. I agree.
Electronic Signature
Date:
Date:
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Step Four

Permit Application Fee:
Shipping Cost
1. Construction on the R.O.W - $50
2. Planting on the R.O.W - $30
3. R.O.W Use Agreement (New) - $350
4. R.O.W. Agreement for in-kind replacement of an existing non-conformity in the same location - $175
5. R.O.W Use Agreement for which recordation in the County Land records is waived - $175
Quantity
Taxable

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Building Permit Application for Projects in the Public Right-of-Way

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