Town of Columbia, N.H.
Application for Zoning Compliance Certificate
Date of this application:_____________________
Name of LANDOWNER:___________________________________________________
Mailing address of landowner:_______________________________________________
Name and address of BUILDING owner if different:_____________________________________
Email and telephone contact number:____________________________________________
Purpose of this application: Residential or non-residential (circle one)
_________To erect or place a building.
_________ To erect or place an addition – attached or detached.
_________ to erect or place a sign.
_________to locate a “temporary” (seasonal) camper trailer.
Building site location: fronts what road?__________________tax map ______lot #_______
Lot size:_____________#feet of road frontage_________ depth:____________
Building purpose:(used for)____________________Size___________Exterior finish:________
Foundation type_______________heat type____________chimney type___________
Draw a sketch on reverse side of this sheet to include all abutters and also include the distances from all of your boundary lines to the proposed building. THIS INFORMATION IS REQUIRED! Incomplete applications will not be processed!
Is this property located within the FLOOD ZONE?________
Are there covenants (restrictions) stated in the deed to this property? ____________________
Does water and sewer meet NH requirements?___yes_____no_____N/A(nonresidential) example:shed
Provide us your NH sewerage disposal Permit # if known______________________
What type of road is this property located on? Approved subdivision road?_____Class VI?____
Class V?______other?____________
Driveway approved by? State_______Town?_____no zoning compliance certificates will be issued without verification of approved driveway installations.
The undersigned declares the above information is correct and complete and the proposed work shall be completed in accordance with all of the Town of Columbia Ordinances and State of NH requirements.
Signature(s) of proposed BUILDING applicant_________________________________________
______________________________________________________________________________
Signature(s) of LANDOWNER(S)_________________________________________________
All approved certificates must be posted at construction site. Certificates expire in ONE year. Remember: It is YOUR RESPONSIBILITY to call 811 up to 30 days before digging!! It is YOUR RESPONSIBILITY to return the certificate/or a completion report or call and let the Planning Board know when building project is completed.
Below lines for Planning Board Use Only.
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Application #____________ Fee Paid- $____________ how?___________:
granted date_________refused date_______revoked date________renewed date________
Any other additional relevant information:
10/9/13
to write yet difficult but it is needful because by itself nothing becomes. lay on a disk and waited so far will remember it. It is possible to understand it but it is not so idle.