Application for Apron/Driveway/Sidewalk Permit
Applicant’s signature Print name Date
Section 1 – General Information
PLEASE PRINT OR TYPE
Section 2 – Description of Project (check all that apply)
Contractor is required to schedule a rough-in inspection before any concealment.
By signing the application, the applicant certifies that the installation will comply with the regulations of the Newburgh Heights
Building Code and State Codes.
TO THE BUILDING COMMISSIONER: This application is submitted for a permit to erect, add to, alter or repair a structure as described
in this application and any drawings which accompany it. The acceptance of the permit shall be considered an agreement on the part of the
applicant or his agents to comply with the Building and Zoning codes of the City of Newburgh Heights, or other orders, requirements or
specifications slated in the permit.
In signing this application, the contractor or owner’s agent certifies that the work is authorized by the owner or record.
Applicant is Owner Contractor Owner’s agent
Permit No. Date Received
Estimated cost of Project $
Date
Apron (must be concrete)
street curb curb cut
(Note: Street curbs, street aprons and
walkways must be installed in concrete)
Parking Pad (site plan required)
full partial (50% or less)
concrete
asphalt
other
Parking lot
sq. ft
concrete
asphalt
Patio (site plan required)
full partial (50% or less)
concrete
brick
other
Sidewalk (must be concrete)
full partial (50% or less)
Service walk (no asphalt walks)
full partial (50% or less)
concrete
brick
other
Driveway
full partial (50% or less)
concrete
asphalt resurface (existing base)
asphalt new
other
Will there be a driveway expansion?
(site plans required) yes no
Will driveway edges extend beyond the
approach to the garage? yes no
Does the driveway have a reverse slope
toward the garage? yes no
Will a catch basin or drain tile be
installed? yes no
Property classification: single two/three family commercial
Notes:
Village of Newburgh Heights Housing and Building Department
3801 Harvard Ave., Newburgh Heights OH 44105 Phone: 216-641-4654
Address of construction ____________________________________________________________________________
Owner’s name ___________________________________________________ Phone ___________________________
Owner’s address __________________________________________________________________________________
Contractor ______________________________________________ Business phone ___________________________
E-mail address ________________________________________________________
Contractor’s address _______________________________________________________________________________
Street City State Zip
