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. <br /> . � � <br /> REQUIRED SUBMITTALS: , - <br /> All of the information must be submitted in order for your application to be processed: ' - <br /> Not � : - . <br /> Enclosed A licable " � <br /> � ❑ Permit A lication <br /> ❑ � Plan Review Fee <br /> ❑ Pool Plans <br /> p ❑ Surve includes radin lan <br /> ❑ Hardcover Calculation Worksheets <br /> ❑ � Erosion Control Plan or co of MCWD Permit <br /> ❑ [S Se tic S stem Certification <br /> ❑ B Wetland Buffer Im rovement Plan <br /> ❑ Escrow& Escrow A reement <br /> ❑ � Other <br /> ❑ � Other <br /> � ❑ Other <br /> ❑ ❑ <br /> APPLICANT ACKNOWLEDGEMENT: � � ` ` � <br /> • Agrees to provide all information required or requested by the Planning&Building Departments; � <br /> . . <br /> • Certifies that the information Supplied is true and correct to the best of his/her knowledge. The'applicant recognizes that they <br /> are solely responsibl8 for submitting a Complete application being aware,that upon failure tv clo so, the's�taff has no alternative <br /> • but to rej�ct it until it i�complete; "• • • " '� � ` � • • • <br /> ' • , . , , , • . <br /> • Some or all of the information that you are asked to provide on thi5 a��lication•is classified by^State 4aw•as either private or <br /> confidential. Private data is information which generally cannot be given to the public but can be given to the subject of the data. <br /> Confidential data is information which generally cannot be given to either the public or the subject of the data. Our purpose and <br /> intended use of this information is to annually update our.r�cords and reco�d�qf-oXher gqvemm�ental,agencies required by law. <br /> If you refuse to supply the information,the permit may not be issued. � <br /> ,. . , <br /> a.�i.,� ` l� �ZC� <br /> ApplicanYs Signature: Date: �( <br /> Owner's Signature Date: <br /> • I , <br />