Rev 12/2017
City of Manchester
14318 Manchester Road
Manchester, MO 63011
P: (636) 227-1385 ex. 118
F: (636) 821-8099
pandz@manchestermo.gov
PROJECT ADDRESS:___________________________________________________________________________
Owner:_______________________________________________________________________________________
Address:__________________________________________ Phone:______________________________
City, State, Zip:_____________________________________ Email:______________________________
Applicant:____________________________________________________________________________________
Address:__________________________________________ Phone:______________________________
City, State, Zip:_____________________________________ Email:______________________________
THIS IS NOT A PERMIT. This is only an application of notification for the City of Manchester and acts as
authorization for St. Louis County to issue permits. Two sets of disconnect and County Health Department information
is required. A non-refundable $25 fee is required.
Square Footage of Property
(Footprint):
Exterior Building Material
(Describe):
Stories: One Story Two Story
MSD Sewer Disconnected: Yes No
Water Disconnected: Yes No
Electric Disconnected: Yes No
IMORTANT: A letter from each utility company and County Health Department must accompany this application.
County Health Dept. – Asbestos: Yes No
I hereby certify that the information contained in this application and accompanying documents are correct, and that I
will conform to all applicable laws of the City of Manchester.
Applicant Signature:______________________________________________________Date:___________________
Applicant’s Name Printed:_________________________________________________________________________
Zoning Fees Fee paid on:______________________ Amount:_____________________
ZONING APPROVAL City of Manchester Permit #:____________________
Approved by:______________________________________________________Date:________________________
Director, Planning, Zoning and Economic Development
FOR OFFICE USE ONLY BELOW
Application for
Demolition
From:_____________ To:_____________ Total Days:_____________
sq. ft.
