Temporary Pool Registration

First Name *

Last Name *

Address *

City *

State *
AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareWashington DCFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming

Zip *

Phone *

Alternate Phone

Email *

Address *

City *

State *
AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareWashington DCFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming

Zip *

Pool Manufacturer

Pool Size

Total Cost of Pool

Type of pool ladder:
Removable LadderLocking Ladder
Location of pool:
Rear YardSide Yard

Is there a fence surrounding the pool?
YesNo
Is there a fence surrounding the yard?
YesNo

Diagram

Please provide an aerial drawing/sketch of the pool with all four (4) dimensions. Dimensions are from:

• both side yard property lines to the pool

• front yard property line to the pool

• rear yard property line to the pool

Requirements

• all pools must be located at least 10 feet from all property lines

• all pools must have a locking or removable ladder

• at no time can a pool be located in the front yard of any property

• all pools MUST be removed by the 180-day expiration date

• all pools are required to be registered; if you purchase or erect a "new" pool, you are required to register the "new" pool with the Bureau of Codes

It is required that all swimming pools containing water more than 24 inches in depth shall be completely surrounded by a fence or barrier at least 48 inches in height above the finished ground level. Gates and doors in such barriers shall be self-closing and self-latching. Gate locks lower than 54 inches high shall be located on the poolside of the gate.

I, the above-signed state that all information provided is true to the best of my knowledge. I know and understand that failure to remove the temporary pool by the expiration of this registration could prohibit me from obtaining a temporary pool registration in the future.
Applicant Signature: