VILLAGE OF LITHOPOLIS

33 N. MARKET ST.

PO BOX 278

LITHOPOLIS, OH  43136

Application for Zoning Permit and Certificate of Occupancy

Date of Application _______________________          Application No. ________________

Applicant’s Name ____________________________________ Phone No.______________

Physical Address _______________________________________________________________

                                            House No.                        Street Address

Mailing Address ________________________________________________________________

       House No. & Street or PO Box                                    City                            State                  Zip

Existing Use of Property ________________________________________________________________

Proposed Use of Property (with zoning change)______________________________________

Description of Change(s) to be Made ______________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

Presently Zoned _________________________________ Building Height _________________

Number of Dwelling Units ____________________ Parking Spaces ______________________

Miscellaneous Information ______________________________________________________________

Signature of Applicant _________________________________________________________________

*************************************************************************************

FOR OFFICIAL USE ONLY

Date App. Rec’d ____________ Date Approved _____________ Date Denied _____________ 

Sewer Permit Rec’d ________ Sewer Tap Fee Pd. _________ Bldg. Permit Req’d    YES     NO

Water Permit Rec’d _________ Water Tap Fee Paid _________  Zoning Fee Paid ___________

Received by ______________________ Title ________________ Date____________
 

Fence Permit Fee $15.00                                             Zoning Permit Fee $100.00

**Application must be completed and submitted with copies of survey of property outlining existing property lines, buildings etc. and proposed work to be done. Once the application has been approved by zoning, you will be contacted to pick approved application up.  Should your project require a building permit, you will need to obtain it from Groveport.  Their phone number is 836-5301.  Please note the Village of Lithopolis has up to 30 days to process your zoning request.