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2. *COMMISSION USE ONLY

   PERMIIT NO:____________________________

   DATE APPROVED:________________________

   DATE ISSUED:___________________________

   COMMISSION:___________________________

   BULDING OFFICAL:_______________________

6. *Submittal Requires color sample and materials list
8. Application Date:*
   Application Date:
10. Property Address1:*
12. Lot #:
13. Parcel #:*
15. Located between:(street names)
17. Description of Project/Business Name & Type *
19. Estimated Start Date:
20. Estimated Finish Date:
21. Estimated Cost: $*
23. Type of Improvement:*
    -- Select One --New ConstructionAdditionAlterationRepair/ReplaceDemolitionOther
25. Application For: Choose all that applies*

    1. Foundation
    2. Masonry
    3. Wood Siding and Trim
    4. Roof
    5. Gutters and Downspouts
    6. Windows
    7. Doors and Entrances
    8. Porches and Stoops

    1. Storefronts
    2. Signage
    3. Awnings
    4. Cornices, Parapets and Upper Facades
    5. Color change
    6. Garages and Outbuildings
    7. Retaining Walls and Landscaping Features
    8. New Construction and Additions

    1. Fencing
    2. Lighting
    3. Parking
    4. Furniture and Artwork in Public Right of Way
    5. Adaptive use
    6. Access for Disabled
    7. Other
27. Other:
29. Applicant Name:*
31. Applicant Address:*
32. Applicant Address2:
34. City*
35. State*
36. Zip*
38. Applicant Phone No:*
39. Applicant Email:*
41. Property Owner Name*
43. Property Owner Address:*
44. Property Owner Address2:
46. City*
47. State*
48. Zip*
50. Property Owner Phone No:*
51. Property Owner Email:*
53. Phone No.*
54. Property Owner Email:*
56. Design Professional:*
    -- Select One --ArchitectEngineerOther
57. Other:
59. Design Professional Name:
61. Design Professional Address:
62. Address2:
64. City
65. State
66. Zip
68. Phone No:
69. Design Professional Email:
73. Design Guidelines:

    PROVIDE SPECIFIC MANUFACTURER'S CUT SHEETS OR CATALOG, PAINT COLORS, MATERIALS, DRAWINGS, ETC.

     ATTACH ADDITIONAL PAGES AS NECESSARY.  FILL IN ALL THAT APPLY

75. FOUNDATION:
77. MASONRY:
79. WOOD SIDING AND TRIM:
81. ROOF:
83. GUTTERS AND DOWNSPOUTS:
85. WINDOWS:
87. DOORS AND ENTRANCES:
89. PORCHES AND STOOPS:
91. STOREFRONTS:
93. SIGNAGE:
95. AWNINGS:
97. CORNICES, PARPETS AND UPPER FACADES:
99. COLOR CHANGE:
101. GARAGES AND OUTBUILDINGS:
103. RETAINING WALLS AND LANDSCAPING FEATURES:
105. NEW CONSTRUCTION AND ADDITIONS:
107. FENCING:
109. LIGHTING:
111. PARKING:
113. FUNITURE AND ARTWORK IN PUBLIC RIGHT OF WAY:
115. ADAPTIVE USE:
117. ACCESS FOR DISABLED:
119. OTHER:
123. CERTIFICATION: Read the below section, sign, date and attach any supporting documents

     I FULLY UNDERSTAND THAT NO EXCAVATION, CONSTRUCTION, OR STRUCTURAL ALTERATION CAN BE UNDERTAKEN UNTIL THE "APPLICATION FOR APPROPRIATENESS" IS APPROVED BY THE HISTORIC LANCASTER COMMISSION AND GIVEN BACK TO THE APPLICANT. I HEREBY CERTIFY THAT I AM THE OWNER OF THE NAMED PROPERTY, OR THAT THE PROPOSED WORK IS AUTHORIZED BY THE OWNER OF RECORD AND THAT I HAVE BEEN AUTHORIZED BY THE OWNER TO MAKE THIS APPLICATION AS HIS/HER AUTHORIZED AGENT AND AGREE TO CONFORM TO ALL APPLICABLE LAWS OF THIS JURISDICTION ON THIS DATE:

125. Signature of Owner/Applicant: *
126. Date:*
     Date:
128. UPLOAD SUPPORTING DOCUMENTS:

     Or email to buildingsubmittal@ci.lancaster.oh.us or building@ci.lancaster.oh.us

Leave This Blank:


129. 1. Receive an email copy of this form.
130. Email address

     This field is not part of the form submission.

131. Submit Submit and Print

* indicates a required field