Forms • McCook, NE • CivicEngage

Job Address:*

PROPERTY OWNER INFORMATION

Name:*

Address:*

City/State/Zip:*

Phone:*

Email Address:

Date:*

Do you have a contractor doing the work?*

Yes

No

*If Yes, please complete the following section.

CONTRACTOR INFORMATION

Name:

Address:

City/State/Zip:

Phone:

Email Address:

Date:

Is the Contractor licensed?*

Yes

No

Type of Work:*

	New Construction
	Addition
	Alteration

	Replacement
	Other

Category of Construction:*

	1 & 2 Family Dwelling
	Multifamily
	Accessory Building

	Commercial/Industrial
	Other

Type of Occupancy:*

Zoning District:

Flood Zone:

Yes

No

Description of Work
(include size/square footage)*

Total Project Cost*

* Include a Site Plan depicting the locations of the existing construction setbacks and the proposed construction setbacks.

* Include a detailed set of plans showing all details necessary to construct the structure to meet all applicable code requirements.

*Check the Red Willow County Register of Deeds office for any restrictions or covenants in our construction area.

NOTE: If project is commercial/industrial construction, the State Fire Marshall's office will need to be contacted for any plan review fees and specifications for building plans, if required:
Address: 246 South 14th St., Lincoln, NE 68508
Phone: 402-471-2027

* indicates required fields.

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