C411M Survey of Residential Attachment B

Attachment B

C-411(M)

FORM
(05-13-2014)

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

SURVEY OF RESIDENTIAL
BUILDING OR ZONING PERMIT SYSTEMS

Economics and Statistics Administration

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

We would appreciate your response within 30 days
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?
Yes–Go to B below

No – Stop! Please return this form now.

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.)

1

Building Permits
Commercial
Residential
Number of Units
Number of Units
2
3
4
5+
1
2
3
4
5+

1

Zoning Permits
Residential
Commercial
Number of Units
Number of Units
2
3
4
5+ 1
2
3
4
5+

Municipality (city,
borough, town,
township, or village)
County, Borough, or
Parish
State
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 area of the city, town, village, borough, or township

or
Only a portion of the city, town, village, borough, or township - Describe the area(s) covered below (Additional space in
Section 4)

B. Does your office issue permits for other municipalities?
Yes - Please list the name(s) of the other municipalities below (Additional space in Section 4)

No

C. Is a portion of your municipality located in another county?
Yes - Please list the name(s) of the other county(ies) - (Additional space in Section 4)

No

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(M) (05-13-2014)