WILLIAMS COUNTY BUILDING PERMIT APPLICATION
	Complete highlighted sections
		Permit #
	Section 5713.7 of the Ohio Revised Code requires each individual or owner to
	notify the County Auditor of construction or improvements of real estate property.
	OWNER OF PROPERTY
	Name _____________________________________________________
	Address of New Construction __________________________________
	DESCRIPTION OF PROPERTY
	Township__________________________________________________
	Parcel Number______________________________________________
	Legal Description____________________________________________
	TYPE OF PROPERTY
	Type of Building ____________________________________________
	Cost of Building ____________________________________________
	Date of Completion __________________________________________
	Contractor Name ___________________________________________
	HEALTH DEPARTMENT
	Sewage Application Number __________________________________
	Water/Well Application Number _______________________________
	Referred for Flood Permit:			Yes ______     No ______
	Referred for County Sewer Tap:			Yes ______     No ______
	Signature__________________________ Date ___________________
	COUNTY SEWER TAP
	Signature__________________________ Date ___________________
	REGIONAL PLANNING
	Flood Plain ________________  County Address _________________
	Signature__________________________ Date ___________________
	$25.00 fee required for any improvement in excess of $2000 value.
	Person Reporting ___________________________________________
	Date of Report ______________________________________________
	Mail with $25.00 check to:
		Williams County Auditor
		One Courthouse Square
		Bryan, OH 43506