c411 C Survey of Residential Attachment C

Attachment C

C-411(C)

FORM
(05-13-2014)

OMB No. 0607-0350: Approval Expires 10/31/2014
U.S. DEPARTMENT OF COMMERCE
Economics and Statistics Administration

SURVEY OF RESIDENTIAL
BUILDING OR ZONING PERMIT SYSTEMS

U.S. CENSUS BUREAU

Person Completing
This Survey
Name
Title
Telephone (Include area code)

Sample Form

Fax (Include area code)
E-mail address
Internet web address

This survey form is used to help us
identify permit-issuing jurisdictions
in the United States.
(Please correct any errors in name, address, and ZIP Code)
Mail or Fax to:

We would appreciate your response within 30 days

U.S. Census Bureau
Manufacturing and Construction Division
Residential Construction Branch
Washington, DC 20233–6900
(Fax) 1–301–763–8587

For further information call 1–800–845–8244
Section 1 – Permit System

A. If a new residential housing unit were to be constructed, would a building/zoning permit be required?
No – Stop! Please return this form now.

Yes – Go to B below

B. What types of permits are required? (Please exclude: Driveway, Electrical, Inspection, Plumbing and Septic permits)
Building (Include Land Use and Site permits)

Other - Please
describe:

Zoning

C. What types of permits are required for the following structures and who issues these permits? (Place an "X" in the
appropriate boxes.)

Building Permits
Residential
Number of Units
1

2

3

4

Zoning Permits

Commercial
Number of Units
5+

1

2

3

4

Residential
Number of Units
5+

1

2

3

4

Commercial
Number of Units
5+

1

2

3

4

5+

County, Borough, or
Parish
Other (i.e., Third Party
Agency, etc.)
If "Other" in Section 1, C. is completed, please enter the name, address, and telephone number of the office that issues
your permits:

Name
Address
Telephone (Include area code)

Please Continue on Reverse Side

Section 2 – Geographic Coverage
A. What is the geographic area covered by your office? (Select only one)
Entire county (includes all of the incorporated and unincorporated places)

or
Entire unincorporated area only

or
Entire unincorporated area and some of the incorporated places – List below (Additional space in Section 4)

or
Part of the unincorporated area only – List below (Additional space in Section 4)

or
Part of the unincorporated area and some or all of the incorporated places – List below (Additional space in Section 4)

B. Does your office issue permits for other jurisdictions in another county?

Yes - Please list the municipality(ies) along with their respective county(ies). (Additional space in Section 4)
Municipality(ies)

County(ies)

Section 3 – Information on Permits Issued
Last year (January – December), how many building permits were issued for new housing units in your jurisdiction?
(Providing an estimate is acceptable)

Section 4 – Comments/Additional Information
Please include any additional information from Sections 1 and 2 that would not fit in the space provided.

(If more space is needed, please attach a separate sheet.)
FORM C-411(C) (05-13--2014)

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