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Department of Community Development, 200 N. Second St., St. Charles, MO 63301
Phone: (636) 949-3227 Fax: (636) 949-3557
Floodplain Development Permit Application
Application No: ______________
Floodplain Development Permits are issued on the condition that the lowest floor (including basement floor)
of any new or substantially improved building shall be elevated to a level at or above the base (100 year) flood
elevation. Additionally, the developer/owner must provide certification of the “as built” lowest floor elevation
(including basement floor). An engineer, architect, or land surveyor registered with the State of Missouri must
provide this certification.
Property Owner/Applicant (please print):
Name: ____________________________________________________________________________________
Address: __________________________________________________________________________________
Daytime Phone: _____________________________________ Fax: ___________________________________
Email: ____________________________________________________________________________________
Builder (please print):
Name: ____________________________________________________________________________________
Address: __________________________________________________________________________________
Daytime Phone: _____________________________________ Fax: ___________________________________
Description of Existing Property:
Address: __________________________________________________________________________________
Size of Property: ____________________________________________________________________________
Legal Description: ___________________________________________________________________________
Assessed Value: $ ___________________________________________________________________________
Is this property located in a designated floodway? Yes No
If yes, certification must be provided to issuance of permit that the proposed development will result in no
increase in the base (100 year) flood elevation.
Is this property located in a designated flood plain fringe? Yes No
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Department of Community Development, 200 N. Second St., St. Charles, MO 63301
Phone: (636) 949-3227 Fax: (636) 949-3557
Description of Proposed Development:
Construction Filling Grading Excavation Flood Damage Repair
Description of Development: __________________________________________________________________
__________________________________________________________________________________________
Size of Structure (sq. ft.): _____________________________________________________________________
Existing Use of Property: _____________________________________________________________________
Value of Improvements: $_____________________________________________________________________
Is a U.S. Army Corps of Engineers 404 permit required? Yes No
Is a Missouri Department of Natural Resources permit required? Yes No
Elevation above mean sea level: 100-year flood level ___________________________________________ ft.
Proposed development site: ________________________________________________________________ ft.
Elevation/flood proofing requirement: ________________________________________________________ ft.
Data Source: _______________________________________________________________________________
The undersigned hereby makes application for a permit to develop in a floodplain. The work to be performed,
including flood protection work, is described above and in attachments hereto. The undersigned agrees that
all such work shall be done in accordance with the requirements of the Flood Damage Prevention Ordinance
and with all other applicable City ordinances, as well as State of Missouri laws and regulations.
Signature of Applicant: __________________________________________ Date: _______________________
FOR INTERNAL USE ONLY:
The above applicant and any attached plans and specifications for a Floodplain Development Permit is
hereby officially approved / denied this ________ day of ________________________, 20_____.
Signature of Authorizing official: _____________________________________________________________
Print Name and Title: ______________________________________________________________________
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