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Page 1 (City of St. Marys)

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MUST 

 

 

Page 2 BUILDING SECTION













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 





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 





















ZONING SECTION













 





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\PermitApplications\20 200213Zoning PermitApplicationsFillable



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

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 



 

 





 





Page 3 of3

\PermitApplications\20200213ZoningPermitApplicationFillable

[City of St. Marys Use Only]

Application Number: Date Received:

Zoning District: PERMIT FEE: $25.00

Tax Parcel ID#: [ ] CASH [ ] CHECK #

Subdivision: Lot#: RECEIPT #

Complete all applicable information. Be specific and descriptive. Do not omit important entries such as telephone numbers, Fed ID Numbers

etc. INCLUDING SIGNATURES.

[ Please Print ]

( If applicable )

Work Site Address: Agent:

Property Owner: Agent Address:

Mailing Address: City, ST, Zip:

City, ST, Zip: Agent Telephone:

Telephone: Agent Fax:

Email: Agent Email:

Architect / Engineer:

Address:

City, ST, Zip:

Telephone Number: Fax Number:

Email:

CERTIFICATION:

I hereby c

ertify that I am the owner of record of the named property, or that the proposed work is authorized by the owner of record, and that

I have been authorized by the owner to make this application as his/her authorized agent, and I agree to conform to all applicable laws of this

jurisdiction. In addition, if a permit for work described in this application is issued, I certify that the Code Official or his authorized

representative(s) shall have the authority to enter areas covered by such permit at any reasonable time to enforce the provisions of the code(s)

applicable to such permit.

Signature of Owner / Authorized Agent Date

\PermitApplications/20200211ZoningPermitApplicationFillable

Page 1 of 5

ZONING PERMIT APPLICATION

CODE ENFORCEMENT DEPARTMENT

11 Lafayette Street

Saint Marys, PA 15857

Phone (814) 781-1718 x227

www.stmaryspa.gov Fax (814) 834-1304

click to sign

signature

click to edit

BUILDING SECTION

[ ] RESIDENTIAL [ ] COMMERCIAL [ ] INDUSTRIAL

Type of Construction: Residential Use:

Type of Foundation: Commercial Use:

Size of Improvement: Industrial Use:

ZONING SECTION

Lot Width: feet Lot Depth: feet

Front Setback: feet Rear Setback: feet

Side Setback: feet Side Setback: feet

Number of Stories: Total Height: feet

I hereby certify that the information contained in this permit application is accurate to the best of my knowledge and any incorrect,

inaccurate, or omitted information, whether intentional or not, may result in the revocation of all or part of the permit approval, and is

considered a violation of the City of St. Marys Zoning Ordinance of 2005 and may result in paying a judgment of $500, plus all court costs

and reasonable attorneys fees incurred by the City as a result thereof. I also hereby certify that I am the owner of record or the agent of the

owner of record, and am authorized to make this application.

(Signature Owner / Authorized Agent)

\PermitApplications/20200211ZoningPermitApplicationFillable Page 2 of 5

Description of Work:

click to sign

signature

click to edit

City of St. Marys Use Only (Entire Page)

RECOMMENDATION OF ZONING OFFICER

Zoning Application: [ ] Approved [ ] Denied (cite specific section of Zoning Ordinance):

Appealed and referred to the Zoning Hearing Board for:

[ ] Variance [ ] Special Exception [ ] Interpretation

Fee: [ ] Cash [ ] Check # Receipt #

Fee Received By: Date:

Zoning Officer: Date:

ACTION TAKEN BY ZONING HEARING BOARD

[ ] Variance Granted [ ] Special Exception Granted [ ] Application Denied [ ] Application Misinterpreted

According to Section(s)

of the City of St. Marys Zoning Ordinance of 2005.

Zoning Hearing Board Chairperson: Date:

ACTION TAKEN BY CITY COUNCIL

Conditional Use Zoning Application: [ ] Approved [ ] Denied

City Council: Date:

Mayor

Attest: Date:

Secretary

\PermitApplications/20200211ZoningPermitApplicationFillable Page 3 of 5

City of St. Marys

Small Project Stormwater Management Application

The Stormwater Management Ordinance requires a Small Project Stormwater Management Application be submitted whenever

more than 1,000 square feet of impervious surface is proposed.

Impervious surfaces are areas that prevent the infiltration of water into the ground and shall include, but not be limited to roofs,

patios, garages, storage sheds, streets, sidewalks, driveways, and parking areas.

Table F-1

To Calculate Impervious Surfaces Please Complete This Table

Surface Type

Length

Width

Proposed Surface Area

Building

Driveway

Parking Areas

Patios/Walks

Other

Total Impervious Surface Area Proposed (Sum of All Areas)

NOTE: The City of St. Marys can require the applicant to provide supplemental and additional information beyond the Small

Project SWM Application if there is a threat to property, health or safety.

Property Owner should consult Section 202 of Chapter 26 of the St. Marys City Code Book for additional information on

compliance requirements.

Property Owner Acknowledges that submission of inaccurate information may result in a stop work order or permit revocation.

Acknowledgement of such is by signature below. I declare that I am the owner or the owner’s legal representative. I further

acknowledge that the information provided is accurate and City employees are granted access to the above-described property

for review and inspection as may be required. Further, I declare the issuance of a permit, waiver, or exemption by the City of St.

Marys in no way relieves me from complying with State Water Quality Standards or actions posing a threat to property, health or

safety. The City of St. Marys assumes no responsibility for the implementation, proper construction, or future compliance with

Chapter 26.

(Print Name)

: Owner Date:

(Signature)

\PermitApplications/20200211ZoningPermitApplicationFillable Page 4 of 5

click to sign

signature

click to edit

REGULAR LOT

REAR

FRONT



























 









FRONT



•

























RR

CORNER LOT



SIDE

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Completed 24 January 2021

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