Ashland City Fire, Building &
Life Safety Department
101 Court Street
Ashland City TN 37015
Fire & Life Safety: (615) 792-4531 – Building Codes (615) 792-6455
Permit No.____________
Approved by:_________
Date:________________
Application for Swimming Pool Permit
Permit Fee: $25.00
Property
Owner &
Location
Name:________________________________________________________
Address: ________________________________________________________
Subdivision: ________________ Lot #: _______County: __________________
Contact Phone #:___________________________________
Contractor
(License &
Insurance
Required for jobs
$25,000 and
above)
TN License # ______________________ Insurance # ____________________
Name: __________________________________________________________
Address: ________________________________________________________
City/State: _________________________________ Zip: __________________
Phone:_____________________ Email: _______________________________
____ Residential
____ Alarm System
____ Gate
____ Commercial
____ Barrier around ladder
____ In-ground pool (Size ___x___)
____ Above-ground pool (Size ___x___)
____ Deck (around pool) (Size ___x___)
How near to:
House ______ (minimum 5 feet) Total cost of Pool: _______________
Right Property Line _____
Left Property Line _____
Rear Property Line _____
Provide an informal plot plan locating the pool & distances from all property lines and house.
Will any portion of the construction be taking place within a flood plain? _________________
Any excavation to soil necessities location of existing septic system. I confirm that I locate the septic
system and no excavation will compromise it. _____________ (Owner’s initials required)
_______________________________________
Applicant Signature Date
_______________________________________
Building Inspector Signature Date
