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2. Office Use Only:

   Permit # associated: __________________________________________

6. Pool Data Sheet: Compliance with Appendix G

   Please submit this form with Pool Application.

8. Site Address1*
10. What type of pool:*
    -- Select One --Above GroundIn Ground
11. Above Ground: Will it have a "lock-out" type ladder?*

    YES or NO

12. In Ground: Will it have a mechanical retractable cover?*

    YES or NO

14. Maximum water level:*
16. Fence Type:*
    -- Select One --ExistingNewOther
17. Fence height:*
18. Fence type:*

    If new - provide specifications and graphics for review

20. Are there gates allowing access to pool area?*
    -- Select One --YESNO
21. Is the dwelling part if the barrier to the pool area?
    -- Select One --YESNO
23. How many doors lead to the pool area from the house?*
24. Will the door(s) have an audible alarm?
    -- Select One --YESNO
26. Will the pool have the following?

    If yes to any of these , provide locations and specifications.

28. Additional lighting added?*
    -- Select One --YesNo

    If yes, provide locations and specifications.

29. Pool pump?*
    -- Select One --YESNO

    If yes, provide locations and specifications

30. Pool Heater?*
    -- Select One --YESNO

    If yes, provide locations and specifications.

32. Wiring Type:

    Please provide electric wiring specifications.

34. Signature: *
35. Date:*
    Date:
37. UPLOAD ANY SUPPORTING DOCUMENTS:

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

Leave This Blank:


38. 1. Receive an email copy of this form.
39. Email address

    This field is not part of the form submission.

40. Submit

* indicates a required field