2. Driveway Permit
   Driveway Permit
3. Price
4. Quantity
5. Shipping Cost
7. Taxable

9. IMPORTANT:

   This form is for driveway replacement with no modification of or expansion to additional space. If you are adding additional space, a plot plan must be submitted by email to mgeiss@perrytwp.org. Thank you.

   Submitting this permit application to Perry Township establishes the property owner’s consent for and authorization of Township staff member(s), including, but not limited to, the Township Zoning Inspector or his/her designee, to enter upon the project property and inspect the property and structure(s) in order to determine whether to issue a Zoning Certificate of Compliance.
   

11. Applicant Name*
13. Address of Property*
15. City
16. State
17. Zip
19. Phone (999-999-9999)*
23. Mailing Address*
25. City
26. State
27. Zip
29. Work Phone (999-999-9999)
30. Email*
34. Name of Property Owner if Other than Applicant
36. Owner Phone (999-999-9999)
37. Email
39. Owner Mailing Address
41. City
42. State
43. Zip
47. Additional Comments
51. Zoning Department Use
    Permit Number _________________________
    
    Receipt # _________________________
    
    Approved By _________________________
    
    Date _________________________
    
    
53. 08/12/21
Leave This Blank:


54. Calculate Totals Proceed to Checkout

* indicates a required field