Building Permit Application

Camelot Forest Conservation Association, Inc.
PO Box 18, Blakeslee, PA 18610-0018       (570) 646-0813      *      (570) 643-7225 fax

Permit Application for New Building
New Home $200 permit fee Permit Application for Change to Existing Home
No Fee Required

Owner's Name (print)______________________________________      Section & Lot # ________________
Owner's Mailing Address___________________________________      Phone________________________
Contractor:___________________________________       Area Code & Telephone #:__________________
Contractor Mailing Address: ________________________________________________________________
Project Contact Person:__________________________      Contact Phone Number____________________
Construction Start Date:_____________________         Expected completion date:_____________________
NEW HOME:
*Before any new home construction begins, this application must be submitted along with a copy of the required supporting documents (Tobyhanna Township Building Permit, plans, surveys, specifications, plot plan, exterior color samples) and Building Fee.
*Minimum square footage requirement is 1,600 sq. ft. No Construction of any kind may begin without the signed, written approval of the Camelot Forest Conservation Association, Inc.
*Waste water disposal requirements coincide with those of Tobyhanna Township, therefore, approval of Tobyhanna Township requirements is considered as approval by Camelot Forest.
*Tree cutting is limited by Camelot Forest Building Code No. 4. DO NOT remove trees unnecessarily.
CHANGE TO EXISTING HOME: Building Addition       Exterior Color Change (samples required)
Shed       Garage       Pool       Tree Removal       Other   explain:______________________
_______________________________________________________________________________________
*A signed copy of this form will be returned to the applicant upon approval. I/we, the undersigned, have read and understand the Camelot Forest Conservation Association, Inc.'s Deed Restrictions and Building Code Policy (attached) and by signing this form, agree to adhere to same. I/we also authorize the CFCA Homesite Committee to enter the property for the purpose of inspection. I/we also agree that CFCA assumes no responsibility for the structural integrity or the workmanship involved during or upon completion of the construction. I/we agree to furnish CFCA with a copy of a Certificate of Occupancy upon completion.
Signatures:
Owners:_______________________________________________________      Date:_________________
Contractor's Representative:_______________________________________      Date:_________________
--------------------------------------------------Do Not Write Below This Line----------------------------------------------------

Date Application Received:  ______________       Approved       Denied      Date:_________________
Reason Denied:__________________________________________________________________________
Application approved by:___________________________________________________________________
(Member, Camelot Forest Homesite Committee)

	Permit Application for New Building New Home $200 permit fee	Permit Application for Change to Existing Home No Fee Required

Owner's Name (print)______________________________________ Section & Lot # ________________ Owner's Mailing Address___________________________________ Phone________________________ Contractor:___________________________________ Area Code & Telephone #:__________________ Contractor Mailing Address: ________________________________________________________________ Project Contact Person:__________________________ Contact Phone Number____________________ Construction Start Date:_____________________ Expected completion date:_____________________ NEW HOME: Before any new home construction begins, this application must be submitted along with a copy of the required supporting documents (Tobyhanna Township Building Permit, plans, surveys, specifications, plot plan, exterior color samples) and Building Fee. Minimum square footage requirement is 1,600 sq. ft. No Construction of any kind may begin without the signed, written approval of the Camelot Forest Conservation Association, Inc. Waste water disposal requirements coincide with those of Tobyhanna Township, therefore, approval of Tobyhanna Township requirements is considered as approval by Camelot Forest. Tree cutting is limited by Camelot Forest Building Code No. 4. DO NOT remove trees unnecessarily. CHANGE TO EXISTING HOME: Building Addition Exterior Color Change (samples required) Shed Garage Pool Tree Removal Other explain:______________________ _______________________________________________________________________________________ A signed copy of this form will be returned to the applicant upon approval. I/we, the undersigned, have read and understand the Camelot Forest Conservation Association, Inc.'s Deed Restrictions and Building Code Policy (attached) and by signing this form, agree to adhere to same. I/we also authorize the CFCA Homesite Committee to enter the property for the purpose of inspection. I/we also agree that CFCA assumes no responsibility for the structural integrity or the workmanship involved during or upon completion of the construction. I/we agree to furnish CFCA with a copy of a Certificate of Occupancy upon completion. Signatures: Owners:_______________________________________________________ Date:_________________ Contractor's Representative:_______________________________________ Date:_________________ --------------------------------------------------Do Not Write Below This Line----------------------------------------------------* Date Application Received: ______________ Approved Denied Date:_________________ Reason Denied:__________________________________________________________________________ Application approved by:___________________________________________________________________ (Member, Camelot Forest Homesite Committee)