APPLICATION FOR PAVING PERMIT (905.09)                                 Fee:_______________________

Owner: __________________________________________________  Telephone:__________________

Address:_____________________________________________________________________________

Contractor: _______________________________________________  Telephone:__________________

Address:_____________________________________________________________________________

ROSSFORD MUNICIPAL CODE REQUIRES ALL CONTRACTORS WORKING WITHIN THE CITY TO BE LICENSED.

Legal Description:______________________________________________________________________

Number of square feet of proposed walk or driveway:__________________________________________

Width of present walk, driveway or curb opening:_____________________________________________

Material in present walk:_________________________________________________________________

Material to be used:____________________________________________________________________

I HEREBY DECLARE THAT ALL ABOVE INFORMATION IS CORRECT.

Signed:______________________________________________________________________________

Date:________________________________________________________________________________
***********************************************************************************************************************
APPROVED/DENIED

____________________________________________________     Date:__________________________
        Zoning Inspector

____________________________________________________     Date:__________________________
        City Administrator

NOTE: Permit shall be kept on the site of construction/reconstruction until completion of work.
***********************************************************************************************************************
Fees:           Curb Cut:                                            $25.00

                   Sidewalk/Driveway                               $25.00