Fillable BUILDING PERMIT APPLICATION (Billings County Courthouse)

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BUILDING PERMIT APPLICATION (Billings County Courthouse)

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BROWSE BILLINGS COUNTY COURTHOUSE (ND) FORMS

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Revised 08/2017 Page 1 of 2
Billings County, ND
Billings County Courthouse; 495 4
th
St.
PO Box 247, Medora, ND 58645
Building Department & Inspections
Phone 701-260-5373
www.billingscountynd.gov
Permit No: ______________
BUILDING PERMIT APPLICATION
(ALL INFORMATION IS REQUIRED)
Plans shall include:
1. (2) Sets of plans to scale, (1/4" or 1/8"). Plans must list total square footage of finished and unfinished space for every level and garage. They must also list
square footage for decks, porches and entry ways. Plan must also show exterior elevations, including all sides of building and all openings in walls
such as doors and windows.
2. A site plan containing the legal description, site address, and name of builder. The site plan must also show the proposed building footprint including distances to
property lines, streets, roads, alleys, and easements. It must also include lot dimensions, lot square footage, driveway location and location of existing street light
poles, junction boxes, hydrants, storm inlets, and utility boxes in the lot, boulevard or curb. The plot plan must be completed and stamped and signed by a
Registered Land Surveyor.
Received:
Other Submittal Requirements:
1. A road approach permit must be submitted.
2. The address of the property must be recorded.
3. Provide a copy of an approved Septic Permit.
4. Please see the Residential or Commercial Plan Submittal Requirements for additional materials to include with the Building Permit Application.
1. PROJECT INFORMATION
Property Owner:
Phone Number: Email:
Contractor:
Phone Number: Email:
Applicant:
Phone Number: Email:
ND Contractor License Number:
Property Address:
Legal Description:
Parcel Number:
Commercial:
Manufactured:
Modular:
2. DESCRIPTION OF WORK (Check all that apply)
Construction Type
New Construction:
Alteration:
Addition:
Foundation Type
Slab on Grade:
Crawl Space:
Basement:
Description of Proposed Work:
Revised 08/2017 Page 2 of 2
3. ZONING INFORMATION (Must Be Completed For Review)
New
Addition
Alteration
Demolition
Miscellaneous
Occupancy Group:
Division:
Census Code:
Ownership:
# Living Units:
Stories:
Construction Type:
Front
Width:
Rear
Width:
Building
Width:
Zoning:
Lot Area (acres):
Easement:
Front Yard Setback: Side Yard Setbacks: Rear Yard Setback:
Zoning Approval Signature: Date:
4. PERMIT DEPOSIT CALCULATION (Office use only)
Deposit MUST be made at time
of Submittal.
RESIDENTIAL:
Deposit:
Total Permit Fee:
Balance Due:
Residential Single Family
$200.00
Modular/Manufactured
$200.00
COMMERCIAL:
Deposit:
Total Permit Fee:
Balance Due:
0 to 4,999 Sq. Ft.
$1,000.00
5,000 to 9,000 Sq. Ft.
$2,000.00
10,000 Sq. Ft. & Larger
$3,500.00
Credit Card:
Check:
Cash:
Date Paid:
Credit
Card:
Check
Cash
Check:
Cash:
Date Paid:
A member of the Building Department will inform you when the permit has been created. Your signature is required when you pick up the permit. The
property must be clearly identified with an address prior to inspection. Any information the applicant has set forth in this application that is false or
misleading may result in the rejection of the application or revocation of the permit.
Owner/Agent Signature Date
This permit application and associated plans have been reviewed for compliance with the Code. All work associated with this permit is subject to field
inspection by certified individuals during the course of construction. Issuance of this permit is in no way granting any portion of the proposed work to be
completed in a manner contrary to the Code. Construction must commence within (six) months.
Building Permit Official Date
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BUILDING PERMIT APPLICATION (Billings County Courthouse)

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Completed 17 July 2020

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