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Floodplain Management Permit Application

  1. Napa Seal

  2. PBES Head Logo

  3. Floodplain Management Permit Application

  4. Property Owner and Applicant Information

  5. Street City, Zip Code

  6. Street City, Zip Code

  7. 10 Digit Phone Number

  8. 10 Digit Phone Number

  9. Check Applicable Box*

  10. Contractor is the same as:

  11. Project Information

  12. Street City, Zip Code

  13. "###-###-###"

  14. If associated with another permit, please include the permit number.

  15. Is this permit associated with any of the following Permits?*

  16. Is this permit associated with an improvement to an existing structure?*

  17. Was the structure constructed prior to 1980? *

  18. Is this permit associated with placement of fill in a Special Flood Hazard Area?*

  19. Cubic Yards

  20. Application Fees:

  21. Application fee for a processing a floodplain permit is dependent on the type of construction in the special flood hazard area as determined by the Director of Planning, Building & Environmental Services or their designee.

  22. For new building, substantial building remodel, or other Major Construction is $ 698.31 w/Surcharge

  23. For Minor Construction $ 254.12 w/Surcharge

  24. I HEREBY CERTIFY THAT THE INFORMATION SUPPLIED BY MYSELF OR MY REPRESENTATIVE IN CONNECTION WITH THIS PERMIT APPLICATION IS TRUE. THE APPLICANT IS RESPONSIBLE FOR OBTAINING ANY PERMITS REQUIRED BY OTHER AGENCIES.

  25. Electronic Signature Agreement

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

  26. Leave This Blank: