Camden County Planning Department
Permits & Inspections
Data Input Form: Modular / Manufactured Dwelling Application

I  M  P  O  R  T  A  N  T  !  !

This form IS NOT your application. This form is an input form designed to generate your application based on your inputs. After entering your information, you must click the 'Print Application' button to view and print your application. You may also print a blank application and fill it out by hand by clicking the 'Print Blank Application' button before filling in any fields. This input form will not print.

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* = Required Field

Property Owner Information
Owner Name:*
Owner Email:
Owner Phones:Home:      Cell:     Fax:  
Owner Mailing Address: *
  * City:     * State:     * Zip:  
Permit Type: *
Who is doing the work for this project? *
Property Information

Property Address (Project Location): *
 * City:     * State:     * Zip:  
 Project Township:  *   
Dealer Information
 Company Name:   
  Address:   
 City:     State:     Zip:  
  Email:  
  Phone:     Cell:     Fax:    
General Contractor
 First Name:      Last Name:   
  Company Name:   
  License #:  
  Address:   
 City:     State:     Zip:  
  Email:  
  Phone:     Cell:     Fax:    
Setup Contractor
 First Name:      Last Name:   
  Company Name:   
  License #:  
  Setup Bond #:  
  Address:   
 City:     State:     Zip:  
  Email:  
  Phone:     Cell:     Fax:    
Electrical Contractor
 First Name:      Last Name:   
  Company Name:   
  Address:   
 City:     State:     Zip:  
  Email:  
  Phone:     Cell:     Fax:    
  License #:  
Mechanical Contractor
 First Name:      Last Name:   
  Company Name:   
  Address:   
 City:     State:     Zip:  
  Email:  
  Phone:     Cell:     Fax:    
  License #:  
Plumbing Contractor
 First Name:      Last Name:   
  Company Name:   
  Address:   
 City:     State:     Zip:  
  Email:  
  Phone:     Cell:     Fax:    
  License #:  
Project Details

DO YOU NEED A TEMP POLE ?  

MANUFACTURED DWELLING

Manufactured Type:  
Manufactured Dimensions:   X    |   Total Square Footage:  
Manufactured Dwelling Model Year  

Manufactured Dwelling Make  

Manufactured Dwelling Serial Number  

MODULAR DWELLING

Frame Type:  

Modular Dimensions:   X    |  Height:    |  Total Square Footage:  
OTHER PROJECT DETAILS

Number of Bedrooms  

Number of Bathrooms  

Number of Fixtures  



Estimated Total Cost of Home:  $