Improvement Location App – Procedure Permit Number Fee Date MM slash DD slash YYYY Landowner PhoneEmail* Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Applicant PhoneEmail* Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Address or Location of proposed improvements Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code EXISTING AND PROPOSED IMPROVEMENTS: Attach a drawing or sketch of the lot or parcel with the dimensions at an appropriate scale, which must show the location and the size of all existing improvements including but not limited to; primary and accessory buildings; parking areas with number of standard and handicap spaces; driveways; grass; lawn or landscaped areas; adjacent street, roads or highways; public or private; signs; area lighting; storm drainage structures including swales and detention/retention systems; sanitary sewers or on site wastewater treatment facilities; any information required by the Martinsville Drainage and Erosion Control Ordinances. Attach a drawing or sketch showing ALL proposed improvements or changes to the lot or parcel. The proposed improvements and changes may be placed on the same drawing as the existing improvements if the drawing will not be confusing or misleadingAttached FileMax. file size: 128 MB.Proposed UseDescribe in sufficient detail for determination of appropriate zoning districtAre proposed improvements in conformance with current zoning classification and associated development standards? Yes No if NO, stop. An improvement Location Permit cannot be used.Are improvements proposed for public right-of-way? Yes No If the above answer is YES, Do the plans meet City standards and specifications? Yes No If the answer is NO an improvement Location Permit cannot be used.Are improvements to be maintained by the City (sanitary or storm sewers; water mains; street; etc.)? Yes No If Yes, performance and maintenance bonds together with recorded easements are requiredIf NO, who will maintain the improvements? Is drainage or stormwater runoff being increased or changed in any way? Yes No If Yes, a drainage permit is required. Note: Existing singe and two family homes are not required to have a drainage permit.Is 10,000 square feet or more of land being disturbed? Yes No If Yes, an erosion control permit is required.Drainage Permit Number Erosion Control Permit Number
