Fillable Contact Information Project Information City, State, ZIP Code (Village of Newburgh Heights)

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Contact Information Project Information City, State, ZIP Code (Village of Newburgh Heights)

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Village of Newburgh Heights
Application for Planning
Commission
Contact Information
Name of Company
Name of Primary Contact
Street Address
City, State, ZIP Code
Phone
E-Mail Address
Project Information
Name of Project
Project Address
Project Parcel Number(s)
Architect Name & Number
Engineer Name & Number
Project Manager Name &
Number, Email Address
Zoning District
Describe Project
Give a brief description below. Review the attached Site and Design Plans Checklist, if applicable, and be
sure all items are included with the application. Attach Site Plan along with other documentation to be
considered by the board.
Agreement and Signature
All contractors/sub-contractors working in the Village of Newburgh Heights are required by ordinance to
register with the Building Department prior to the start of construction. Contractor registrations and
applications for all permits must be secured prior to the issuance of Building Permits.
Name (printed)
Signature
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Contact Information Project Information City, State, ZIP Code (Village of Newburgh Heights)

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Completed 19 January 2021

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