<p> MARION COUNTY, WEST VIRGINIA FLOODPLAIN DEVELOPMENT PERMIT APPLICATION</p><p>Floodplain Management Program</p><p>Date of Application:______Permit#______</p><p>Application Information *</p><p>Name: ______Mailing Address:______City:______State:______Phone:______</p><p>Contractor Information & License Number (if applicable) </p><p>WV License #: ______City License#______</p><p>Name: ______Mailing Address:______City:______State:______Phone:______</p><p>Property Address: ______</p><p>Cost of Improvement:______</p><p>(Provide directions below, if no address) (Provide Documentation: Tax Map District #, Map #, Parcel #) ______</p><p>Type of Structure: (Check All That Apply) ______Demolition ______Residential ______Commercial/Industrial ______Excavation/Fill Activities ______Garage/Detached Structure ______Manufactured Home ______Other (explain) </p><p>Description of Work To Be Completed : ______</p><p>Signature______Date______</p><p>* APPLICANT WILL PROVIDE ONE COPY OF PLANS AND SPECIFICATIONS OF THE PROPOSED CONSTRUCTION/ PROJECT, ALONG WITH PERMIT APPLICATION. FOR USE BY FLOODPLAIN COORDINATOR PERMIT #______</p><p>IS THE PROPERTY IN FLOOD ZONE (CIRCLE WHICH APPLIES) A AE IN FLOODWAY X</p><p>IS ADDITIONAL INFORMATION REQUIRED? (FIRMette attached) Y N</p><p>ARE OTHER FEDERAL, STATE, OR LOCAL PERMITS REQUIRED? Y N</p><p>ARE OTHER COUNTY REGULATIONS APPLICABLE? Y N</p><p>IS THIS A SUBSTANTIAL IMPROVEMENT? Y N</p><p>HAS THERE BEEN SUBSTANTIAL DAMAGE? Y N</p><p>IS THERE A NON-CONVERSION AGREEMENT Y N</p><p>IS THERE PROPER FLOOD VENTING IN THE FOUNDATION? Y N</p><p>SITE PLANS ATTACHED? Y N</p><p>ELEVATION CERTIFICATE REQUIRED/ATTACHED? Y N</p><p>ESTIMATED COST OF DEVELOPMENT/ IMPROVEMENT $______</p><p>FREEBOARD REQUIRED? Y N HOW MUCH? 1ft 2ft</p><p>( ) PERMIT APPLICATION APPROVED</p><p>( ) PERMIT APPLICATION REJECTED </p><p>SPECIAL INSTRUCTIONS BY THE FLOODPLAIN COORDINATIOR. ______</p><p>______FLOODPLAIN COODINATOR DATE</p>