Flood Hazard Development Permit Application

( All applicants must complete entire application).

Application is herby made for a Flood Hazard Development Permit as required under Article II of the Floodplain Management Ordinance of Rumford, Maine, for development as defined in said ordinance. This permit application does not preclude the need for other municipal permit application.

Owner:        Address Phone No.

Applicant:   Address Phone No.

Contractor: Address Phone No.

Legal Description

Is this lot a part of a subdivision? Yes    No   if yes, give the name of the subdivision and lot number:

Subdivision: Lot#:

Tax Map:    Lot#:

Address:     Street/ Road Name:

Zip Code:  

General explanation of proposed development:

Market Value of existing structure, if applicable:  Estimated value of improvements" 

Attach a Site Plan- Show property boundaries, floodway and floodplain lines and area of proposed development. Show dimensions of the lot; dimensions and location of existing and/or proposed development on the site; areas to be cut and filled. For New Construction or Substantial improvement, also include existing grade elevations done by a Professional Land Surveyor, Architect or Engineer. Substantial Improvement is defined as any reconstruction, rehabilitation, addition or other improvement of a structure, the cost of which equals or exceeds 50 % of the market value of the structure before the start of construction of the improvement. Refer to the floodplain management ordinance, Article XIII, for more complete definitions of the Construction and Substantial Improvement.

Indicate scale and north arrow.

Other Permits

Are other permits required from State or Federal Jurisdictions?     Yes No

If yes, are copies of these permits attached?                                     Yes No Not Applicable

Enter the file to process:
 

 

Type of Development

New development or substantial improvements:

Minor improvement or addition to existing development:

Check appropriate number below on the left for the type(s) of the development requested, and complete information for each applicable line:

  1. Filling                                             1a. Amount of fill in cubic yards
  2. Excavation                                    2a. Amount of excavation in cubic yards
  3. Paving                                          3a. Amount of paving in square yards
  4. Drilling  
  5. Mining                                           5a. Amount of mining in acres
  6. Dredging                                       6a.  Amount of Dredging in cubic yards
  7. Levee                                            7a. Amount of material in levee in cubic yards
  8. Dam                                               8a. Water surface to be created in acres
  9. Water Course Alteration                9a. Detailed description  must be attached with copies of all applicable state and  

                                                                      federal Permit 

  1. Water Dependant use:

        Dock                                          10a. Dimensions of structure

        Pier                                             10b. Dimensions of structure

        Boat ramp                                    10c. Dimensions 

 11. Non-substantial improvement to a structure                   11a. Dimensions of improvement

 12. Substantial improvement to residential structure                12a.Dimensions of structure

                                                                                              12b.Elevation of lowest floor (NGVD)

 13.Substantial improvement to Non Residential Structure   13a. Dimensions of structure

                                                                                              13b. Elevation of lowest floor (NGVD)

14. Flood proofing                                                                 14a. Elevation of lowest level of floodproofing (NGVD)                 

15. Other                                                                                15a. Explain            

 The Applicant Understands and agrees that: 

-The permit applied for, if granted, is issued on the representations made herein;

- Any permit issued may be revoked because of any breach of representation;

- Once the permit is revoked all work shall cease until the permit is reissued or a new permit is issued;

-Any permit issued on this application will not grant any right or privilege to erect any structure or use any permits described for any purpose or in any manner prohibited by the ordinances, codes, or the regulations of the municipality;

- The application herby gives consent to the Code Enforcement Officer to enter and inspect activity cover under the provisions of the Flood Plain Management Ordinance;

- If issued , the permit form will be posted in a conspicuous place on the premises in plan view;

-If issued , the permit will expire if no work is commenced within 180 days of issuance.

I herby certify that all the statements in, and the attachments to this application are a true description of the existing property and the proposed development project.

Owner____________________________      Date:  e.g.( 1971)

Or 

Authorized Agent________________________________      Date:  e.g.( 1971)

Applicant must provide a statement describing how each application development standard

( set forth by ARTICLE VI of the Flood Plaine management Ordinance) will be met.

Note: this application must be filled out, printed and signed and brought to the public works Department and the approved in order to be a valid permit. Submitting this or any of the forms will not validate such applications.