Bloom Township 8490 Lithopolis Road, Carroll, OH 43112 Phone: 614-837-4387 Fax: 614-837-7576 Email: adminoffice@bloomtwp.org

Application for Certificate of Occupancy

Bloom Township, Fairfield County, Ohio

Please note: fill in your details on screen, then print and sign in ink. Signatures must be original — not faxed, copied, or electronic. Make checks or money orders payable to Bloom Township.

Applicant

Before an Occupancy Permit will be granted, the following must be submitted:

  1. Legal Foundation Survey indicating the setbacks for the finished residence.
  2. A signed statement that the residence/property is in full compliance with the Fairfield County Department of Health requirements (below).
  3. A list of any items that still need to be completed before the house is 100% complete.
  4. Certificate of Occupancy fee of $100.00 — check or money order payable to Bloom Township. Cash is not accepted.
Items still to be completed
Applicant signatures (sign in ink after printing)
Zoning Inspector’s decision (office use only)
Occupancy permit

Signed statement of compliance with the Health Department

Compliance statement

I/we, the property owners named above, do swear or affirm that the residence located at the address above in Bloom Township, Fairfield County, Ohio is in full compliance with the Fairfield County Department of Health requirements needed prior to moving into the residence.