ZONING PERMIT
CHARTER TOWNSHIP OF FLUSHING Receipt #____________
6524 N. Seymour Road Date:_______________
Flushing, Michigan 48433 Permit Fee:__________
810-659-0800 Fax 810-659-4212 Initial:______________
APPLICANT TO COMPLETE ALL ITEMS IN SECTIONS. NOTE: SEPARATE APPLICATIONS MUST BE COMPLETED FOR BUILDING, PLUMBING,
MECHANICAL, AND ELECTRICAL PERMITS IF REQUIRED. SOIL EROSION PERMIT THROUGH GENESEE CTY.
Parcel #___________________________ Estimated Value of Structure $_________________________
LOCATION OF BUILDING
STREET LOCATION:_____________________________________________ ZONING DISTRICT:___________________________________
CITY: _______________________STATE:_________________ZIP________ OWNERSHIP: [ ] Private [ ] Public
between _____________________and_______________________________ LOT SIZE: ___________________________________
TYPE OF IMPROVEMENT: RESIDENTIAL PROPOSED USE: NON-RESIDENTIAL PROPOSED USE:
[ ] NEW BUILDING [ ] ONE FAMILY [ ] AMUSEMENT [ ] LIBRARY
[ ] ALTERATION [ ] TWO OR MORE FAMILY ___# UNITS [ ] CHURCH, RELIGION [ ] STORE, MERCANTILE
[ ] DEMOLITION [ ] HOTEL, MOTEL ____# UNITS [ ] INDUSTRIAL [ ] TANKS, TOWERS
[ ] FOUNDATION ONLY [ ] ADDITION [ ] SIGN [ ] PARKING GARAGE [ ] PUBLIC UTILITY
[ ] MOBILE HOME SET-UP [ ] POOL [ ] FENCE [ ] SERVICE STATION [ ] HOSPITAL/INSTITUTE
[ ] PRE-MANUFACTURE [ ] ATTACHED/DETACHED GARAGE [ ] OFFICE,BANK [ ] SIGN
[ ] SPECIAL INSPECTION [ ] DECK [ ] POND [ ] PROFESSIONAL
[ ] RELOCATION [ ] STORAGE SHED [ ] RETENTION AREA
[ ] ADDITION [ ] POLE BUILDING
[ ] REPAIR [ ] OTHER _______________________ [ ] OTHER ___________________________________
NON-RESIDENTIAL DESCRIBE IN DETAIL PROPOSED USE OF BUILDING, E.G. FOOD PROCESSION PLANT, MACHINE SHOP, LAUNDRY
BUILDING , PARKING GARAGE FOR DEPARTMENT STORE. IF USE OS EXISTING BUILDING IS BEING CHANGED ENTER PROPOSED USE.
______________________________________________________________________________________________________________________
CHARACTERISTICS OF BUILDING
PRINCIPAL TYPE OF FRAMING NUMBER OF OFF-STREET PARKING RESIDENTIAL BUILDINGS ONLY
[ ] Masonry (wall bearing) Enclosed________________________ Number of Bedrooms_____________________________
[ ] Wood frame Outdoors________________________ Number of bathrooms_____________________________
[ ] Structural steel Other:___________________________ Number of partial bathrooms________________________
[ ] Reinforced concrete
DIMENSIONS
No. of Stories__________________ Total square feet of floor area_________ Total land area square feet/acres____________________
IDENTIFICATION OF APPLICANT
APPLICANT IS RESPONSIBLE FOR ALL FEES APPLICABLE TO THIS APPLICATION AND MUST PROVIDE THE FOLLOWING INFORMATION:
OWNER OR LESSE: ____________________________________________ADDRESS:_________________________________________________
CITY:____________________________________STATE:_______________ZIP:____________ PHONE NUMBER:__________________________
CONTRACTOR:________________________________________________ADDRESS:_________________________________________________
CITY :___________________________________STATE:_______________ZIP:_____________PHONE NUMBER:__________________________
BUILDERS LICENSE #_____________________EXPIRATION DATE:_____________________
I HEREBY CERTIFY THAT THE PROPOSED WORK IS AUTHORIZED BY THE OWNER OF RECORD AND THAT I HAVE BEEN AUTHORIZED BY
THE OWNER TO MAKE THIS APPLICATION AS HIS/HER AUTHORIZED AGENT, AND WE AGREE TO CONFORM TO ALL APPLICABLE LAWS OF
THE STATE OF MICHIGAN, GENESEE COUNTY AND THE TOWNSHIP OF FLUSHING, ALL INFORMATION SUBMITTED ON THIS APPLICATION
IS ACCURATE TO THE BEST OF MY KNOWLEDGE.
SIGNATURE OF APPLICANT: ___________________________________________________________DATE:____________________________
SITE PLAN: USE BELOW SPACE OR ATTACH SITE PLAN
[ ] LABLE STREETS [ ] LABLE FRONT YARD LINE [ ] LABLE SIDE YARD LINES [ ] LABLE REAR YARD LINE
[ ] EXISTING BLDGS [ ] DISTANCE BETWEEN BLDGS [ ] DISTANCE TO YARD LINES [ ] LABLE DIRECTION N/S/W/E
[ ] DISTANCED BETWEEN EXISTING AND PROPOSED STRUCTURES
APPROVAL SIGNATURE: ___________________________________________________DATE:____________________________
