Rev 3/2020
City of Manchester
14318 Manchester Road
Manchester, MO 63011
P: (636) 227-1385 ex. 118
F: (636) 821-8099
pandz@manchestermo.gov
PROPERTY ADDRESS:__________________________________________________________________________
Owner:_______________________________________________________________________________________
Address:__________________________________________ Phone:______________________________
City, State, Zip:_____________________________________ Email:______________________________
Applicant:____________________________________________________________________________________
Address:__________________________________________ Phone:______________________________
City, State, Zip:_____________________________________ Email:______________________________
Inspection Date Requested:______________________
Planning and Zoning Use Only
Inspection #:_____________________________ Date Scheduled:__________________________
Fee paid on:_____________________ Amount:_________________________________
Single Family
Inspection
Application
Expected Date of Occupancy:_______________________
OCCUPANCY PERMIT MUST BE FILLED OUT SEPARATELY BY NEW OCCUPANTS.
• A new application must be completed for every change of owner or tenant (if rental property).
• Violations found in initial inspection must be corrected within
30 days of first inspection; a passed inspection is valid for 90
days.
• Inspection fees are $125 for a condo/house; $45 for a third or fourth inspection required in a 90 day period. Fee must be
paid before an inspection appointment will be scheduled.
• Occupancy Information (separate form) must be completed and received by the City before
the premises are occupied by
new occupants.
No. of Bedrooms:_______________________________
Occupancy Limit:___________________________________
Rental Property? Yes No Don’t know
I hereby agree to perform all necessary corrections if premises are found not to be in compliance and that I will
conform to all applicable laws of the City of Manchester.
Owner/Agent
Signature:________________________________________________________________Date:_________________
Name Printed:__________________________________________________________________________________
