Troy, IL · Madison County
Swimming Pool/Spa Homeowner Acknowledgement
Homeowners complete this acknowledgement for a limited-use swimming pool or spa permit and submit it with the permit application and site plan.
What this form is
This form records the homeowner’s agreement to follow the approved plans and applicable city requirements for a swimming pool or spa. The city requires it with the limited-use permit application; approval cannot be issued without the acknowledgement. It asks for the property address, homeowner signatures, dates, and printed names, and describes permit responsibilities such as barriers, alarms, inspections, and reporting infrastructure damage.
Who needs it
The property owner applying for a limited-use swimming pool or spa permit must complete and sign this acknowledgement.
How to submit it
Submit the signed acknowledgement with the limited-use permit application and site plan by email or in person to the Building & Zoning Department, 116 E. Market Street, Troy, Illinois 62294. The document says the permit fee is paid after approval.
About notarization
This document is signed and dated without a notary; it mentions no attachment or related step that must be notarized or sworn.
How to submit this form
- 1
Download The Form
Download the Swimming Pool/Spa Homeowner Acknowledgement.
- 2
Complete And Sign
Enter the property address, sign and date the acknowledgement, and print the homeowner name or names.
- 3
Gather The Application And Site Plan
Include the limited-use permit application and a site plan showing setbacks from property lines and the home.
- 4
Submit To The City
Email or deliver the completed documents to the Building & Zoning Department; the city says the permit fee is paid after approval.
Frequently asked questions
- Do I need a notary for the Swimming Pool/Spa Homeowner Acknowledgement?
- No. This document has homeowner signature and date lines but no notary block or sworn attachment requirement.
- How do I submit the pool or spa homeowner acknowledgement?
- Complete and sign it, then submit it with the limited-use permit application and site plan by email or in person to the Building & Zoning Department.
- What information does the acknowledgement ask for?
- It asks for the property street address, homeowner signature or signatures, dates, and printed names.
- What else must accompany this form?
- The city’s instructions say to submit the acknowledgement with the limited-use permit application and a site plan showing setbacks from property lines and the home.
Need something notarized?
This Swimming Pool/Spa Homeowner Acknowledgement doesn’t need a notary — but Illinois residents can notarize other documents online with a commissioned online notary.