Dingman Township
                           Pike County, PA        

 


                       

Dingman Township

Applications and Forms

Click on the links below to access forms that are required for permit application and other administrative actions.  All forms and applications posted here are in the .pdf format. Forms may also be obtained by visiting or calling the Dingman Township office.

 

Building Department

Go to the Building Department Page for additional information and guidances

Building Permit Application - Part 1

Must be submitted when applying for a building permit to construct a structure or accessory structure

Building Permit Application - Part 2

Must be completed and submitted with an application for a building permit

Certificate of Incumbency - Corporate

Must be submitted with any application where the applicant or property owner is a Corporation.

Certificate of Incumbency - LLC / LLP / LP

Must be submitted with any application where the applicant or property owner is a LLC, LLP, or LP company.

Contractor (Worker's Comp) Affidavit

Must be submitted with ALL applications for a building permit

Change in Contractor Notification

Must be submitted when changing building contractor from that listed at the time of permit application.

Document Box Rental

Must be submitted with ALL applications for a building permit

Modular Home Certification Form

Must be submitted when applying for a building permit to place a modular home

Building Hearing Board Appeal Application

Must be submitted when applying for a hearing before the Building Hearing Board

Building/Zoning/Well Permit Transfer Form

Must be submitted to transfer Building, Zoning, and/or Well permit to a new property owner.  One form may transfer all three permits

Violation Complaint Form

Must be submitted when filing a complaint about a building code violation

 

Open Records Office

Go to the Open Records Page for additional information and guidances

Open Records Office Forms

 

Planning Department

Go to the Planning Department Page for additional information and guidances

Submission Application

Must be submitted with all S.A.L.D.O. review requests

Certificate of Incumbency - Corporation

Must be submitted with any application where the applicant or property owner is a Corporation.

Certificate of Incumbency - LLC / LLP / LP

Must be submitted with any application where the applicant or property owner is a LLC, LLP, or LP company.

S.A.L.D.O. Waiver Application

Must be submitted when requesting a waiver of a S.A.L.D.O requirement

Time Limit Waiver Form

Must be submitted when requesting a waiver of the time limitations

 

Recreation Board

Go to the Recreation Board Page for additional information and guidances

Application to Reserve Fields

Help the Park

 

Road Department

Go to the Road Department Page for additional information and guidances

Driveway Access Permit Application

Must be submitted when constructing a NEW driveway onto a Township Road or when paving or improving a driveway that enters upon a Township road

Certificate of Incumbency - Corporation

Must be submitted with any application where the applicant or property owner is a Corporation.

Certificate of Incumbency - LLC / LLP / LP

Must be submitted with any application where the applicant or property owner is a LLC, LLP, or LP company.

 

Sewage Department

Go to the Sewage Department Page for additional information and guidances

Sewage Permit Application Form

        Must be submitted to apply for all sewage permit types (new, repair, port-a-john, etc.)

Certificate of Incumbency - Corporation

Must be submitted with any application where the applicant or property owner is a Corporation.

Certificate of Incumbency - LLC / LLP / LP

Must be submitted with any application where the applicant or property owner is a LLC, LLP, or LP company.

Sewage System Designer Affidavit

Must be completed by sewage system designer and submitted with the sewage permit application

Non-Surveyor Site Plan Affadavit.docx

Must be submitted when the plans have not be prepared by a Pennsylvania Registered Surveyor

Sewage Permit Transfer Form

Must be submitted when transferring a sewage permit to a new property owner (except A/B Soil Systems and I.R.S.I.S systems)

A/B Soil System Permit Transfer Form

Must be submitted when transferring an A/B Soil System sewage permit to a new property owner

I.R.S.I.S. Sewage Permit Transfer Form

Must be submitted when transferring an IRSIS sewage permit to a new property owner

Violation Complaint Form

Must be submitted when filing a complaint about a sewage violation.

A/B Soil System Operations and Maintenance Agreement (no UV)

Must be submitted prior to applying for an A/B Soil System Permit where the system will not be utilizing UV disinfection

 

Well Department

Go to the Well Department Page for additional information and guidances

Well Permit Application

Must be submitted when applying for a well permit

Non-Surveyor Site Plan Affadavit.docx

Must be submitted when the plans have not be prepared by a Pennsylvania Registered Surveyor

Certificate of Incumbency - Corporation

Must be submitted with any application where the applicant or property owner is a Corporation.

Certificate of Incumbency - LLC / LLP / LP

Must be submitted with any application where the applicant or property owner is a LLC, LLP, or LP company.

Well Permit Application Work Sheet

Must be submitted when applying for a well permit.

Change in Well Driller Notification

Must be submitted when changing well driller from that listed at the time of permit application.

Building/Zoning/Well Permit Transfer Form

Must be submitted to transfer Building, Zoning, and/or Well permit to a new property owner.  One form may transfer all three permits

Violation Complaint Form

Must be submitted when filing a complaint about a well violation.

 

Zoning Department

Go to the Zoning Department Page for additional information and guidances

ZoClick here for forms specific to Lake Adventure Recreational Vehicle Park

Zoning Permit Application

Must be submitted when applying for a zoning permit

Zoning Permit Application Page-2

Must be submitted with the Zoning Permit application

Guidance for Preparing a Zoning Plot Plan

 Information regarding how to prepare a site plan for the    submission of a zoning permit application

Non-Surveyor Site Plan Affadavit.docx

Must be submitted when the plans have not be prepared by a Pennsylvania Registered Surveyor

Certificate of Incumbency - Corporation

Must be submitted with any application where the applicant or property owner is a Corporation.

Certificate of Incumbency - LLC / LLP / LP

Must be submitted with any application where the applicant or property owner is a LLC, LLP, or LP company.

Zoning Permit Work Sheet

Must be submitted with all residential zoning permit applications

Work Sheet for a Transient Residential Use Permit

Must be submitted with a zoning permit application to apply for a Transient Residential Use zoning permit.

Application for 911 Address Sign

Use this form to purchase a blue 911 address sign from the Dingman Township Volunteer Fire Department.

Zoning Permit - Driveway Location Form

Must be submitted with Zoning Permit application when constructing a NEW house or commercial building

No Impact Home-Based Business Work Sheet

Must be submitted with the zoning permit application when applying for a No Impact Home-Based Business zoning permit

Home Occupation Worksheet

Must be submitted with the zoning permit application when applying for a Home Occupation zoning permit

Home Occupation Affidavit

Must be submitted when applying for a Home Occupation zoning permit

Temporary Sign Zoning Permit Application

Must be submitted when applying for a temporary sign zoning permit

Political Sign Registration Form

Must be submitted when you intend to place political signs in the Township

Yard Sale / Garage Sale Zoning Permit Application

Must be submitted to conduct a yard sale, garage sale of similar activity

Application for a Certificate of Non-Conforming Use

Must be submitted to apply for a Certificate of Non-Conforming Use - all properties except those in Lake Adventure.

Application for a Certificate of Non-Conforming Use - Transient Residential Use only

Must be submitted to apply for a Certificate of non-Conforming Use for an existing Transient Residential Use.

Non-Profit Organization Flea Market Zoning Permit Application

Must be submitted to conduct a flea market on behalf of a non-profit organization

Application for Conversion to Different Commercial Use

Must be submitted before converting a residential or commercial use to a different commercial use

Building/Zoning/Well Permit Transfer Form

Must be submitted to transfer Building, Zoning, and/or Well permit to a new property owner.  One form may transfer all three permits

Application for a Variance or Appeal to the Zoning Hearing Board

Use this form to apply for a zoning variance of to appeal the detemination of the Zoning Officer

Violation Complaint Form

Must be submitted when filing a complaint about a zoning violation.

Forms for Lake Adventure

To be used only for properties in the Lake Adventure Recreational Vehicle Park.  All other properties use the forms listed above.

Zoning Permit Application

                   Must be submitted when applying for a zoning permit

        Zoning Permit Work Sheet - Lake Adventure RV Placement

                    Must be submitted with zoning permit application when siting RV

Application for a Certificate of Non-Conforming Use (Lake   Adventure)

 Must be submitted to apply for a Certificate of Non-  Conforming Use - properties in Lake Adventure only.

Application for a Variance or Appeal to the Zoning Hearing Board

Use this form to apply for a zoning variance of to appeal the detemination of the Zoning Officer

 

Other Forms

This form is required by the Pike County Conservation District whenever a project will dig into the ground, distrurb the surface of the earth, or encroach upon surface waters.

Basic Checklist for Information Regarding Permit and Plan Requirements Related to Earth Disturbance Activities and Water Obstructutions and Encroachments 

Employment Application

 

 

 

 
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