GRADING PERMIT APP
Email: TO DEV
Name of Dev to Sign
Email TO
Email of Dev
Parcels
Building Permit #
Water Capacity
Sewer Capacity
Check all that apply
In Floodplain
Conforms with MWS LID
In Combined Sewer System
Variance Requested
Variance Requested
Development Name
Project Description
Address (Property)
Zip (Property)
Company (Owner/Dev)
First Name (Owner/Dev)
Last Name (Owner/Dev)
Address (Owner/Dev)
City (Owner/Dev)
State (Owner/Dev)
Zip (Owner/Dev)
Phone # (Owner/Dev)
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MY NAME
Name 1
NAME 2
Company Name
Address 1
Address 2
Address 3
Phone #
TBD
MY EMAIL
Date
/
Month
/
Day
Year
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