Rev 12/2017
1. Completed Application Form
2. $500 Application Fee, estimated cost of repair of ROW and bond or Letter of Credit for said amount.
3. Two (2) complete sets of plans that include information required by Section 405 Article IX of the Municipal
Code.
THIS IS NOT A BUILDING PERMIT. Construction plans must be submitted to the City of Manchester for
approval and then to St. Louis County for issuance of the building permit and related inspections. Plans must
also be submitted for review to the applicable Fire Protection District. Please contact the appropriate fire district for
additional information. Contact Dig-Rite at 800.344.7483 prior to any digging. If a dumpster is needed at the project
City of Manchester
14318 Manchester Road
Manchester, MO 63011
P: (636) 227-1385 ex. 118
F: (636) 821-8099
pandz@manchestermo.gov
PROJECT ADDRESS:___________________________________________________________________________
Owner:_______________________________________________________________________________________
Address:__________________________________________ Phone:______________________________
City, State, Zip:_____________________________________ Email:______________________________
Applicant:____________________________________________________________________________________
Address:__________________________________________ Phone:______________________________
City, State, Zip:_____________________________________ Email:______________________________
Zoning Fees Fee paid on:______________________ Amount:_____________________
ZONING APPROVAL City of Manchester Permit #:___________________________
Municipal Zoning Classification:____________________________________________________________________
Approved by:______________________________________________________Date:________________________
Director, Planning, Zoning and Economic Development
FOR OFFICE USE ONLY BELOW
Telecommunications
Permit Application
Work Proposed:
Construction Details:
I hereby certify that the information contained in this application and accompanying documents are correct, and that I
will conform to all applicable laws of the City of Manchester.
Applicant Signature:______________________________________________________Date:___________________
Applicant’s Name Printed:_________________________________________________________________________
Date(s) of Work: Start Date:__________________ End Date:__________________
ROW Details:
