Violet Township requires Zoning and Plans Examination and Building Permits for all new construction.

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VIOLET TOWNSHIP ZONING & BUILDING DEPARTMENTS 12970 Rustic Drive Pickerington, Ohio 43147 Zoning (614)575-5560 Building (614)575-5559 Fax (614)575-5562 TO: FROM: All Residential Zoning and Building Permit Applicants Kelly Sarko, Zoning Inspector Don Day, RBO Building Inspector Violet Township requires Zoning and Plans Examination and Building Permits for all new construction. The following items must accompany completed and signed Zoning and Plan Review/Building Permit application forms: 1. A Flood Plain Building Permit is required to be obtained from Fairfield County Regional Planning Commission if a property contains any portion of a regulatory 100-year floodplain. Please contact the Fairfield County Flood Plain Administrator at (740)687-7110 if you are uncertain whether you need to obtain this permit. A Certificate of Zoning Compliance cannot be issued unless this permit has been issued by Fairfield County Regional Planning. 2. A plot plan or suitable drawing (on a sheet no larger than 11" x 17"), drawn to scale, showing all existing structures and their size, the location of the proposed construction on the property and its dimensions to the front, rear and side property lines (setbacks are parallel each property line). 3. A completed and signed AFFIDAVIT FOR PERMIT or HOMEOWNER PERMIT AFFIDAVIT. 4. For any property located on a Township road right-of-way, a Right-of-Way Permit application must be submitted and approved by the Township Engineer. a. Pursuant to Violet Township Trustees Resolution Number 2002-0904-02, a property owner and/or builder must establish a single point of access onto said property, place large gravel within the access and utilize only that access point for all ingress/egress to and from the property during the construction period. b. For installation of a culvert or drain tile in a drainage ditch within a Township road right-of-way, an inspection by the Township Engineer is required prior to covering the culvert with fill material. 5. A DESC (Drainage, Erosion and Sedimentation Control) Permit is required for all new home construction in Violet Township. A plan showing the type and placement of appropriate sedimentation and erosion control devices is required to accompany the completed application form. 6. If the proposed home is not served with public water and/or sewer services, a copy of the approved well and sewer permits issued by the Fairfield County Health Department must be provided. 7. Plans of the proposed building (TWO sets of plans only) including but not limited to: a. Foundation plan with elevations; b. Floor plans showing all levels; spans of main beams, floor joists, rafters and trusses and material types; c. Wall, floor and roof sections showing the type and location of material; d. Elevations of the exterior showing type of material; and e. All applicable mechanical plans that are required to complete the building 8. Application Fees. Permits will not be processed and construction shall not begin until plans examination fees have been received and plans have been approved for construction by the Plans Examiner.

9. ALL STRUCTURES SHALL COMPLY WITH THE 2013 Residential Code of Ohio Violet Township Building Department inspects the following: To Schedule an inspection, please call (614)575-5559. Please give project address and state which time the project will be ready for inspection. 1) Footing all footings must be trenched and forms in place ready for placement of concrete as well as placement of structure for compliance with Township Zoning requirements. 2) Rough Framing all framing must be complete and rough electric, plumbing and heating in place. No insulation or drywall in place. 3) Final Inspection for Certificate of Occupancy Plumbing fixtures set, electric fixtures and devices with covers in place, heating, air conditioning and ventilation with air distribution devices in place. All mechanical equipment must be in working order at this time also. All safety requirements in place. Exterior grading complete. 4) Temporary Occupancy Permit may be obtained for an additional fee, at the discretion of the Building Inspector, if above items are not complete at final inspection. Plan Examination Fee: Plan Examination Fee will be assessed according to the following schedule and will cover the cost of plan reviews by the Plan Examiner: A. One, Two and Three Family Dwelling Units $180.00/unit A deposit of $130.00 for plans examination is required and will not be returnable, but will be credited to the total cost of the permits B. Re-submittal fee for Dwelling Units $ 85.00/unit C. New residential garage and accessory buildings. $ 85.00/unit Addition and alteration to residential buildings, garages and accessory buildings D. A zoning fee for all the above projects will be charged per schedule. Residential Permit Fees: Each Building permit issued under this section shall also be charged a zoning application fee. A blanket residential permit may be issued to construct a new residential dwelling unit(s) (less than four dwelling units), fee does not include: re-inspection, after-hours inspection or temporary occupancy. The blanket permit fee includes Final Certificate of Occupancy and related accessory buildings such as carports and garages, but does not include community spaces, pools, signage, or mail shelters. Figured on gross floor area of all occupy-able spaces, including halls, common areas, stairways, laundry rooms and carports. Blanket permit fees are not refundable. Change of contractor shall be accomplished only by a permit transfer. Fees do not include fireplace. See Schedule C. Permit Expiration will be enforced as established in Section 105 of the 2006 R.C.O. The Building Department will perform courtesy inspections of structural fire damage for Township residents If construction begins prior to the issuance of permits; fees will be doubled PLEASE MAKE CHECKS PAYABLE TO VIOLET TOWNSHIP

Permit No. VIOLET TOWNSHIP APPLICATION FOR CERTIFICATE OF ZONING COMPLIANCE PART I General Information Applicants Name Phone No. Address Owner s Name Phone No. Address Location of Subject Property Subdivision Existing Use of Property Lot Number Existing Zoning Proposed Use or Construction - Describe PART II Usable floor space as living quarters exclusive of basements, porches, garages, breezeways, terraces, attics or partial stories. 1st floor Sq. Ft. 2 nd floor sq. ft. Garage Sq. Ft. Total Living Area sq. ft. Number of Stories Height Off-street parking sq ft. Dimensions of proposed construction: Length Width Height Accessory Bldg. Sq. Ft. Total No. Accessory Buildings and Combined Sq. Ft. Part III Site Plan Requirements The applicant shall submit two (2) copies of a site plan drawn to scale showing the following: (a) (b) (c) (d) (e) (f) The actual dimensions of the lot including easements; The exact size and location of all existing buildings (all accessory buildings and their dimensions must be shown) on the lot; as well as existing and intended uses for the land and buildings; The proposed new construction; The applicant must present written evidence from the Board of Health prior to zoning compliance to ensure that the new accessory structure does not interfere with the proper operation and maintenance of the on-site sewage system. The applicant must submit structural plans for any commercial structure for review by the Fire Department prior to zoning compliance. During construction the contractor must provide a trash bin or dumpster on lot for purpose of containing discarded building materials and other trash.

(g) Lot Size Lot Coverage Sq. Ft. Main Road Frontage Front Setback Side Yard Setbacks: Left Lot Depth Rear Yard Setback Right PART III Review Procedure No existing or new building shall be changed in its use in whole or in part until a zoning permit is approved by the Zoning Inspector. The Zoning Inspector shall have up to fourteen (14) days to review the application and may consult technical agencies prior to approval. PART IV Applicant s Affidavit Application is hereby made for a certificate of zoning compliance. It is understood and agreed by the applicant that any error, misstatement or misrepresentation of fact or expression of fact in the application, either with or without intention on part of the applicant, such as might, or would, operate to cause the issuance of a permit in accordance with this application, shall constitute sufficient ground for the revocation of the certificate of zoning compliance at any time. Applicant s Signature Owner s Signature Date Date Note: No construction shall be allowed within right-of-way until the Violet Township Engineer has approved a Permit to Work in Right-of-Way. The Violet Township Road Department is authorized to stop any and all construction taking place within the right-of-way of any Violet Township Road, unless the Permit to Work in Right-of-Way has been issued. FOR OFFICE USE ONLY Date Received Fee Pd. Receipt No. Date Comments: Action Taken on Application Date of Action Violet Township Zoning Office 12790 Rustic Drive Pickerington, Ohio 43147 (614) 575-5560 Violet Township Zoning Inspector

VIOLET TOWNSHIP BUILDING DEPARTMENT 12970 Rustic Drive Pickerington, Ohio 43147 614/575-5559 FOR DEPARTMENT USE ONLY Permit App. No. Date Received Date Forwarded Date Returned Date Issued APPLICATION FOR PLAN REVIEW AND BUILDING PERMIT SITE ADDRESS: LOT #: SUBDIVISION / PARCEL No.: LOCATED BETWEEN and ZONING DISTRICT: FLOOD PLAIN ZONE: MAP # DEV. PERMIT NO.: DESCRIPTION OF PROJECT: APPLICATION DATE: / / PROJECT COST: $ ESTIMATED STARTING DATE: ESTIMATED FINISH DATE: TYPE OF IMPROVEMENT: NEW CONSTRUCTION ADDITION ALTERATION REPAIR / REPLACEMENT CHANGE OF USE OTHER APPLICATION FOR: BLANKET RESIDENTIAL RESIDENTIAL ADDITION / ALTERATION / ACCESSORY STRUCTURE DEMOLITION BUILDING (STRUCTURAL) SIGN FOUNDATION START FIRE SUPPRESSION PLUMBING MECHANICAL ELECTRICAL FIRE ALARM INDUSTRIALIZED-UNIT OTHER RESIDENTIAL: ONE FAMILY TWO FAMILY THREE FAMILY FOUR OR MORE FAMILY MOBILE HOME COMMERCIAL: OBC USE GROUP: MIXED USE: YES NO IF YES; SEPARATED YES NO OWNERS NAME: ADDRESS: CONSTRUCTION TYPE: IA IB IIA IIB IIIA IIIB IV VA VB E-MAIL ADDRESS: TELEPHONE: FAX: MOBILE: CONTRACTOR: CONTRACTOR REGISTRATION No. ADDRESS: E-MAIL ADDRESS: TELEPHONE: FAX: MOBILE: APPLICANT: ADDRESS: E-MAIL ADDRESS: TELEPHONE: FAX: MOBILE: DESIGN PROFESSIONAL: ARCHITECT / ENGINEER REGISTRATION No.: ADDRESS: E-MAIL ADDRESS: TELEPHONE: FAX: MOBILE:

BUILDING AREA SQUARE FEET AREA NEW & ADDITIONS ALTERATIONS CHANGE OF USE OCCUPANCY LOADS BASEMENT FIRST FLOOR 2, 3, 4 FLOORS, ETC. GARAGE, SHED, DECK, ETC TOTAL AREA SQUARE FEET BUILDING PERMIT RESIDENTIAL COMMERCIAL OTHER BASEMENT: BLOCK POURED WOOD OTHER # OF ROOMS: # OF BEDROOMS: # OF BUILDINGS: # OF UNITS: # OF FULL BATHS: # OF 1/2 BATHS: # OF STORIES HEIGHT IN FEET: A/C: YES NO ELEVATOR: YES NO ELECTRICAL PERMIT TYPE: RESIDENTIAL COMMERCIAL TEMPORARY SERVICE NEW SERVICE ADDITION / ALTERATION REPLACEMENT / REPAIR HOT TUB MOBILE HOME SERVICE OTHER VOLTAGE: PHASE: SERVICE CONDUCTORS: / SET # OF SETS: NUMBER OF METERS: NUMBER OF FIXTURES, SWITCHES, OUTLETS, ETC.: NUMBER OF MAIN DISCONNECTS: NUMBER OF SUB PANELS, DISCONNECTS, ETC.: FIRE ALARM ALARM SYSTEM: YES NO NO. OF DEVICES: TYPE: LOCAL CENTRAL STATION REMOTE STATION PROPRIETARY OTHER FIRE SUPPRESSION SPRINKLERS HOOD SUPPRESSION LIMITED AREA TYPE OF SYSTEM: WET DRY ANTI-FREEZE CHEMICAL OTHER NO. OF HEADS: NO. OF STANDPIPES: NO. OF RISERS: PLUMBING PERMIT NUMBER OF FIXTURES: TYPE OF SYSTEM: MUNICIPAL PRIVATE HVAC PERMIT Describe Heating System: BRAND: MODEL: Describe Cooling System: BRAND: MODEL: TYPE: RESIDENTIAL COMMERCIAL NEW ADDITION ALTERATION # OF UNITS: OUTPUT (BTU/HR): TONS: FUEL TYPE: # OF OUTLETS: FORCED AIR RADIANT GRAVITY INFRARED HEAT PUMP BOILER/STEAM CONDENSING UNIT COOLING TOWER EVAPORATION COOLER FIREPLACE TYPE: MASONRY MANUFACTURERED INSERT

REPLACEMENT / REPAIR STOVE SOLID FUEL GAS LOGS DEMOLITION PERMIT STRUCTURE(S) TO BE: MOVED DEMOLISHED OTHER MOST RECENT USE OF BUILDING(S): RESIDENTIAL NON-RESIDENTIAL SIDEWALK PERMIT TOTAL SQUARE FOOTAGE OF BUILDING(S): PROPOSED USE OF SITE FOLLOWING DEMOLITION: TYPE: NEW REPLACEMENT DRIVEWAY WIDENING APPROACH NEW APPROACH REPLACEMENT SIDEWALK PROGRAM: PHASE EXTERIOR SLAB Two (2) inspections are required. Sidewalk and approach are to be replaced within 7 days of tear out. Call for final inspection when forms a removed and grade work is complete. SIGN PERMIT SIGN HEIGHT: FEET INCHES: SIGN FACE AREA: HT X WD = SQ. FT. IS THERE A COMPREHENSIVE SIGN PLAN FOR THIS SITE? YES NO TYPE: WALL GROUND PROJECTION AWNING CANOPY SUBDIVISION FACE REPLACEMENT OTHER CHARACTERISTICS: DOUBLE FACED PERMANENT TEMPORARY ILLUMINATED NON-ILLUMINATED ON-PREMISE OFF-PREMISE OTHER SWIMMING POOL PERMIT SWIMMING POOL TYPE: ABOVE GROUND IN-GROUND OUTDOOR INDOOR DOES POOL HAVE A DECK/ WALKWAY/ APRON AROUND IT? YES NO CERTIFICATION SIZE: FEET X FEET OR DIA.: FEET TOTAL SQUARE FOOTAGE : HOW IS POOL PROTECTED? 4-FT. MINIMUM BARRIER REQUIRED. FENCED YARD BUILT-IN GUARDRAIL I FULLY UNDERSTAND THAT NO EXCAVATION, CONSTRUCTION, OR STRUCTURAL ALTERATION, ELECTRICAL OR MECHANICAL INSTALLATION OR ALTERATION OF ANY BUILDING, STRUCTURE, SIGN, OR PART THEREOF AND NO USE OF THE ABOVE SHALL BE UNDERTAKEN OR PERFORMED UNTIL THE PERMIT APPLIED FOR HEREIN HAS BEEN APPROVED AND ISSUED BY THE VIOLET TOWNSHIP BUILDING/ZONING DEPARTMENT. 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 I agree to conform to all applicable laws of the jurisdiction. In addition, if a permit for work described in this application is issued, I certify that the code official or the code official s authorized representative shall have the authority to enter areas covered by such permit at any reasonable hour to enforce the provisions of the code(s) applicable to such permit. I HEREBY ACKNOWLEDGE THAT I HAVE READ AND FULLY UNDERSTAND THE ABOVE LISTED INSTRUCTIONS. SIGNATURE OF APPLICANT: HOLD / DATE: REASON: DATE: PRINT NAME: INCOMPLETE COMPLETE APPROVED DISAPPROVED BUILDING OFFICIAL: PLANS EXAMINER:

VIOLET TOWNSHIP BUILDING AND ZONING DEPARTMENT 12970 RUSTIC DRIVE, PICKERINGTON, OHIO, 43147 AFFIDAVIT FOR BUILDING PERMIT PROPERTY OWNER OF RECORD Permit No. Name (Please Print) Mailing Address Telephone # City/State/Zip FAX # Email Address AGENT FOR OWNER CONTRACTOR TENANT ARCHITECT/ENGINEER ATTORNEY PLAN SERVICE FIRM OTHER Name (Please Print) Mailing Address Telephone # City/State/Zip FAX # Email Address AFFIDAVIT (please check one) I am the owner of this 1-, or 2-Family Residential or Miscellaneous Construction Which is located in Violet Township, Fairfield County, Ohio at: NUMBER STREET CITY ZIP I understand that additional permits may be required in order to perform work in the road right-of-way I understand that all work will comply with the 2003 International Residential Code I understand that the placement of all structures and their uses will comply with the regulations specified in the Violet Township Zoning Resolution I understand that this affidavit is important and I have told the truth on it and all attached papers. Name and signature below must match applicant information on the attached Building Permit Application form. PRINT NAME SIGNATURE Notary Seal Here NOTARY PUBLIC OR ZONING & BUILDING DEPARTMENT OFFICIAL FALSIFICATION OF A PUBLIC DOCUMENT IS A VIOLATION OF THE OHIO REVISED CODE, SECTION 2921.13(A)(3), A MISDEMEANOR OF THE FIRST DEGREE, PUNISHABLE BY UP TO SIX (6) MONTHS IMPRISONMENT AND A FINE OF $1,000 OR BOTH.