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Master Land Use Permit Application <br />Updated April 13, 2021 Page 2 of 4 <br />CRITICAL AREAS OR BUFFERS ON SITE OR WITHIN 300 FEET: <br />¨ Yes / Type ____________________________ ¨ No <br />WATER BODIES WITHIN 200 FEET: <br />¨ Yes / Name:_____________________________ ¨ No <br />FLOODPLAIN: <br />Flood Zone: FIRM Panel # Date of Panel: <br />LOT COVERAGE AREA CALCULATIONS: <br />Existing Square Footage: Proposed Square Footage: <br />IMPERVIOUS SURFACE AREA CALCULATIONS: <br />Existing Impervious Square Footage: New Impervious Surface: <br /> DESCRIPTION OF SUBJECT PROPOSAL: ¨ Additional pages attached <br />PROPOSED WORK: __ <br /> _________ <br /> _________ <br /> _________ <br /> _________ <br /> <br />_____________________________________________________________________________________________________ <br />_________________________________________________________________________________________________ <br />PROPERTY OWNER INFORMATION: ¨ Multiple owners attached <br />NAME:MAILING ADDRESS: <br />CITY, STATE, ZIP:PHONE #: <br />FAX #:EMAIL ADDRESS: <br />APPLICANT INFORMATION: ¨ Same as property owner <br />NAME:MAILING ADDRESS: <br />CITY, STATE, ZIP:PHONE #: <br />FAX #:EMAIL ADDRESS: <br />CONTACT PERSON: ¨ Same as property owner ¨ Same as applicant <br />NAME:MAILING ADDRESS: <br />CITY, STATE, ZIP:PHONE #: <br />FAX #:EMAIL ADDRESS: