Fill - Free fillable FORM-Fire-Waiver - Fire Waiver

FIREPROTECTIONREQUIREMENTWAIVER



PursuanttoSection1.13.1oftheZoningOrdinance,publicwaterlinesshallbeavailabletothesitesufficienttome etfire

protectionstandardsofWarrenCounty.



WarrenCounty:250GPMat20PSIforsinglefamilyresidential



Owner(s)ofsitesthatdonotmeet

therequirementslistedabovemaychooseanyofthefollowingoptionsinorderto

complywithSection1.13.1oftheZoningOrdinance:



a. Servicingwaterlinesshallbeimprovedinsuchamannerthat250GPMat20PSIisachievedatthesite

b. Analternativefireprotectionplan,

preparedbyaprofessionalengineermeetingthespecifica tionsof

NFPA13,13D,13R,750and/or1142,shallbesubmittedandapprovedbytheWarrenCountyPublic

WorksDirector

c. Atthetimeofthefilingofanyapplicationforabuildingpermit,theFireProtectionrequirements

(agriculture,ruralresidential,andresidential

estatedistricts)intheWarrenCountyunincorporatedarea

maybewaivedbytheCountyBuildingInspectorortheWarrenCountyPublicWorksDirectororhisor

herdesignee



Ifthepropertyowner(s)electtoprocee dwithaFireProtectionRequirementWaiver,pleasecompletetheapplication

below.



Theapplicationisforasingle‐familyresidentialstructure: 



NameofPropertyOwner(s):_______________________________________________________

LocationofProperty:________________SizeofProperty:_____________________

LotNumber:________________Su bdivision Name:___________________________DeedBook/Page:_______

BuildingPermitNumber:________________



Icertifythattheaboveinformationistrueandaccurate.Iunderstandthattheabovereferencedpropertydoesnothave

publicwatersupplyavailablewhichwillmeettheminimumfirefloworpressure.Nevertheless,Irequestthatthe

minimumfireflowand/orpressurerequirementbewaivedformyproperty.



_______________________________________________________________________________________________

PropertyOwner(s)SignatureDatePropertyOwner(s)SignatureDate



Thepropertyownerhasbeenmadeawarethattheirpropertydoesnothavepublicwatersu pplyavailablewhichwill

meettheminimumfirefloworpressure,havebeenadvisedofavailableoptionsfortheirpropertytomeetthefire

protectionrequirements,andhassignedthisWaiverpursuanttoSection1.13.1

oftheZoningOrdinance.



___________________________________________________________________________________________

WarrenCountyPublicWorks    Date

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FORM-Fire-Waiver - Fire Waiver_08012012

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