Jackson County Planning & Zoning BZA Agenda.pdfPlanning & Zoning 111 south main st. brownstown, in...
Transcript of Jackson County Planning & Zoning BZA Agenda.pdfPlanning & Zoning 111 south main st. brownstown, in...
March 10TH 2020 Board of Zoning Appeals Agenda
The Jackson County Board of Zoning Appeals will meet Tuesday, March 10th 2020 for their regularly scheduled meeting at 7:30 PM at the Jackson County Courthouse, 111 S. Main St. Brownstown, IN. 47220.
+ ROLL CALL
+ APPROVAL OF MINUTES
+ FINDING OF FACTS
+ NEW BUSINESS- Application 20-12535 Texas Eastern Products Co. Construction of new 5,394' sq. ft. operational building and parking areaw/ associated infrastructure. (Section 7-2 Uses (S))
+ OLD BUSINESS- Miscellaneous
+ ADJOURNMENT
Jackson CountyPlanning & Zoning 111 south main st. brownstown, in 47220
[email protected] | (812) 358-6109
BZA
E COUNTY ROAD 1000 N (35' R/W)
30"
36"
165647.90RIPRAP S429 S
166647.89RIPRAP PC429 PC
167647.52RIPRAP O C429 O C
168647.56RIPRAP O C429 O C
169647.74RIPRAP PT CL 114429 PT CL 114
178647.56RIPRAP S429 S
179648.01RIPRAP429
180647.87RIPRAP429
181647.40RIPRAP429
182647.24RIPRAP CL429 CL
153648.27CHK PTCK101
90646.11CHK PTCK102282646.10CHK PTCK102
144650.84CHK PTCK103
SET
SET
BENCHMARK #105ELEVATION=647.56
PIPEPAINT/FLAG
PIPEPAINT/FLAG
PIPEPAINT/FLAGP
290645.68S ECURITY ACCESS PED ~ call box8 12 ~ c all box
CALLBOX
220646.72PIPE - PAINT/FLAG E663 E
221645.82PIPE - PAINT/FLAG E663a E
222644.94PIPE - PAINT/FLAG E663b E
N. LINE OF THE NW 1/4 SEC. 27
SEC. 27, T7N, R6ESEC. 22, T7N, R6E
283647.09TRF LO O P ~ 5x14ft931 ~ 5x14ft
284646.92TRF LO O P ~ 3x14ft931 ~ 3x14ft
285646.84TRF LO O P ~ 3x14ft931 ~ 3x14ft
286646.49TRF LO O P ~ 5x14ft931 ~ 5x14ft
287646.27TRF LO O P ~ 5x14ft931 ~ 5x14ft
266646.14E M ISC PT ~ gate sensor799 ~ gate sensor
267645.92E PANEL S710 S268645.79E PANEL E710 E
274645.85E PAINT/FLAG S703 S
275645.96E PAINT/FLAG703
277646.14E PAINT/FLAG703
278646.39E PAINT/FLAG PC703 PC
279646.49E PAINT/FLAG O C703 O C
280646.68E PAINT/FLAG PT703 PT
281646.24E PAINT/FLAG E703 E
173647.34D IP <S ~ 8in>4 80 S ~ 8in
174647.02DIP <E>480 E
9643.98RCP <S>450 S
10643.42R CP <E ~ ap prox line>4 50 E ~ ap prox line
333645.36P VC <~ 4in>4 60 ~ 4in
155650.62CHAIN FENCE S 54251 S 54
158651.40CHAIN FENCE 54251 54
32650.95CHAIN FENCE 54251 54
39648.68CHAIN FENCE 54251 54
63647.77CHAIN FENCE 54251 54
64647.25CHAIN FENCE 54251 54
79646.66CHAIN FENCE S ~ 8ft251a S ~ 8ft
80646.88CHAIN FENCE E251a E
88646.20CHAIN FENCE 54251 54
295645.81CHAIN FENCE S 267 E 54251 S 267 E 54
298645.60CHAIN FENCE 54251 54
299645.39CHAIN FENCE 54251 54
300645.03CHAIN FENCE 54251 54
225645.67RW ALL TO P S 171 S172 S 171 S
226645.58RW ALL BTM171227645.29RW ALL BTM171
229647.39RW ALL TO P 61 S PC172 61 S PC
231647.43RW ALL TO P E172 E
232645.10RW ALL BTM171
233645.41RW ALL BTM171
234645.57RW ALL BTM E 114 S171 E 114 S
237647.12RW ALL BTM S171 S
238645.67RW ALL BTM171
241645.27RW ALL BTM1713645.51RW ALL BTM171
6647.03RW ALL BTM E171 E
255646.57CRO WN S123 S
256647.18CROW N123
261646.77CROW N123
293646.34CRO WN E123 E
309646.13CRO WN S123 S
312646.19CROW N123
315646.22CROW N123
322646.34CROW N123
329646.69CROW N123
339647.46CROW N123
343648.22CROW N123
121649.23CROW N123
128650.49CROW N123
131650.93CROW N123
134651.15CROW N123
139651.15CRO WN E123 E
187645.29BO S S60 S
188643.82BO S60
189643.68BO S60
190644.64BO S60
191645.76BO S E60 E
205647.46TO S O C61 O C
206647.26TO S PT61 PT
207647.09TO S E 10061 E 100
211643.39BO S 11460 114
212643.95BO S 11460 114
223647.45TO S S PC61 S PC
224647.26TO S O C61 O C
228647.41TO S PT E 17261 PT E 172
230647.20TO S O C61 O C
11644.79SW ALE FL S62 S
12645.10SW ALE FL62
13645.72SW ALE FL62
14646.54SW ALE FL E62 E
19647.96G RADE BREAK S53 S
20648.47G RADE BREAK53
21648.72G RADE BREAK E53 E
160649.02G RO UND ELEV54
163648.67G RO UND ELEV54
171647.85G RO UND ELEV54
172649.25G RO UND ELEV54
183646.52G RO UND ELEV54
184647.80G RO UND ELEV54
185645.16G RO UND ELEV54
186644.55G RO UND ELEV54
18645.52G RO UND ELEV54
22648.13G RO UND ELEV54
23647.21G RO UND ELEV54
24646.84G RO UND ELEV54
25648.50G RO UND ELEV54
26648.08G RO UND ELEV54
27649.23G RO UND ELEV54
28650.50G RO UND ELEV54
29650.23G RO UND ELEV54
30650.51G RO UND ELEV54
31650.73G RO UND ELEV54
40649.92G RO UND ELEV54
42647.24G RO UND ELEV54
44646.06G RO UND ELEV54
57646.21G RO UND ELEV54
58647.45G RO UND ELEV54
60648.75G RO UND ELEV54
67647.52G RO UND ELEV54
68647.84G RO UND ELEV54
69647.12G RO UND ELEV54
70646.05G RO UND ELEV54
73644.94G RO UND ELEV54
82646.50G RO UND ELEV54
83647.58G RO UND ELEV54
84646.97G RO UND ELEV54
SET
252645.84G RO UND ELEV54
253646.29G RO UND ELEV54
276645.69G RO UND ELEV 25154 251
289645.75G RO UND ELEV 25154 251
291646.01G RO UND ELEV 251 E 267 S54 251 E 267 S
301645.28G RO UND ELEV 251 E54 251 E
337647.02G RO UND ELEV54
116647.48G RO UND ELEV54
119648.47G RO UND ELEV54
321645.49G PAINT/FLAG603
123649.10G PAINT/FLAG603
124650.46G PAINT/FLAG603
143650.92G PAINT/FLAG E603 E
325644.72W PAINT/FLAG S503 S
334646.25W PAINT/FLAG ~ O K503P ~ O K
SET
81646.68BLDG CO RNER156P
95646.62BLDG CO RNER156P
96646.48BLDG CO RNER156P
97646.40BLDG CO RNER156P
154650.43EO G S114 S
156651.20EOG114
157651.25EOG114
159650.49EOG114
161649.07EOG114
162648.88EOG114
164647.88EOG114
170648.12EO G E114 E
175647.93EO G S PC114 S PC
176647.84EO G OC114 O C
177647.97EO G PT114 PT
192647.57EOG114
193647.20EOG114
194647.28EOG114
195 647.43EO G E114 E
197647.48EO A O C100 O C
198647.82EO A PT100 PT
199647.75EO A100
200647.86EO A E100 E
202647.61EO A O C100 O C
213644.59EOG114
215646.95EO G E114 E
218644.37EOG114
219646.84EO G E 100114 E 100
235647.22EO G 61 PT114 61 PT
236647.96EO C S103 S
239648.21EO C103
240648.26EO C103
4648.30EO C103
5647.94EO C CL103 CL
7647.84EO A S100a S
8647.47EO A100a
15646.94EO G 61 E114 61 E
16646.66EOG114
17645.36EOG114
33650.84EO G S 114a S114b S 114a S
34651.02EOG114b
35651.21EOG114b
36651.13EOG114b
37649.04EOG114b
38648.64EOG114a
43645.85EOG114
45646.83EO A100a
46646.64EO A100
47646.65EO G S114c S
48646.25EOG114c
49645.30EOG114c
55646.50EO A100
56646.60EO A100a
61648.01EOG114b
62647.71EOG114a
65647.30EOG114a
66647.38EOG114b
71646.24EO A100a
72646.10EO A100
76646.76EO C103
77647.16EO C103
78647.00EO C CL103 CL
85646.08EOG114b
86646.00EOG114b
87646.00EO G E 114a E114b E 114a E
92645.41EO A100
93646.01EO A100a
94646.83EO A E100a E
98646.38EO G S114 S
99646.76EOG114
SET
SET
SET
SET
SET
110645.70EO G OC114a O C
244645.62EO G OC114a O C
245645.91EO A100
246645.83EO G PT E 100114a PT E 100
247645.86EO A E100 E
248645.92EO A S PC100 S PC
249645.94EO A O C100 O C
250646.46EO A PT100 PT
251646.20ASPH101
254646.69EO A100
257646.82EO A100a
258647.00EOG114
259646.20EOG114
260646.30EO A100a
262646.33EO A100
269646.23EOG114
270646.28EOG114
271645.73EOG114
272646.03EOG114
273646.11EOG114
292645.98EO A100a
294645.86EO A100
296645.65EO A100
297645.58EO A100
302644.84EO G S 603 S114 S 603 S
303645.91EO A100
304646.01EO A100
305646.05EO A100
306645.97EO A E100 E
307644.87EOG114
308645.56EO G E114 E
310645.88EO A S100 S
311645.94EO A100
313646.00EO A100
314645.88EO A100
316645.90ASPH101
317646.06EO A PC100a PC
318646.05EO A O C100a O C
319645.94EO A PT100a PT
320646.19EO A100a
326646.10EO A100
327646.15EO A100
328646.34EO A100
330646.59EO A100a
331646.40EO G S114 S
332645.92EOG114
336646.88EOG114
338647.60EO A100a
340646.60EO A100
342647.72EO A100
115648.29EO A100a
117647.37EOG114
118648.62EOG114
120649.33EO A100a
125650.42EOG114
126650.18EO G E114 E
127650.54EO A100a
129650.04EO A100
130650.46EO A100
132651.08EO A100a133651.23EO A100a
135650.58EO A100
138650.93EO A E100 E
140650.96EO A E100a E
141651.03EO G S114 S
142651.09EO G E114 E
TRAFFIC
LOOP
TRAFFIC LOOP
8" PIPEELEV=647.02
38.98' ~8"
DUCTI LE
IRON
@ 0.82%
8" PIPEELEV=647.34
RIPRAP
RIPRAP
RCP PIPEELEV=643.98
APPROX.
LINE
4" PVCELEV=645.36
4" PVCELEV=645.8440.38'~4" PVC
@ 1.19%
CONCRETEHEADWALL
RCP PIPE
FIREEXTINGUISHER
335646.55G UY ~ 1327919 ~ 1327
GUY POLE
GRAVEL
GRAVEL
EDGE OF GRAVEL
EDGE OF GRAVEL
EDGE OF GRAVEL
EDGE OF GRAVEL
GRAVEL
GRAVEL
GRAVEL
GRAVEL
GRAVEL
CONCRETE
ASPHALT
EDGE OF ASPHALT
EDGE OF ASPHALT
ASPHALT
EDGE OF ASPHALT
EDGE OF ASPHALT
ASPHALT
EDGE OF ASPHALT
EDGE OF ASPHALT
ASPHALT
ASPHALT
ASPHALT
GRASS
GRASS
GRASS
GRASS
GRASS
GRASSGRASS
GRASS
GRASS
GRASS
GRASS
GRASS
GRASS
GRASS
RASIEDCONCRETE
214646.44SIG N ~ 69kv 23ft 08277 ~ 69kv 23ft 08
EX SIGNDANGER69KV HIGH VOLTAGE23' OVERHEAD
CHAINLINKFENCE 8' HIGH
CHAINLINKFENCE
CHAINLINKFENCE
GATE
SET
SET
SET
17.5'
17.5'
17.5'
263644.50PO ST276
288645.95M AILBO X269P
BOLLARD5.67'(TYP.)
BOLLARD
MAILBOX
FLAG POLEW/36" DIA.CONC. BASE
E264645.87E PED ~ gate m otor707 ~ gate m otor
E265645.98E PED ~ gate m otor707 ~ gate m otor
GATEMOTOR
GATESENSOR
GATESENSOR
GATEMOTOR
ELECTRICPANEL
324645.84U PO LE 901922 901
122649.51U PO LE 701 701a 701b922 701 701a 701b
E. COUNTY RD 1000 N
GATEFENCE
DUMPSTER
ENTRY
EXIT
GATE
EXISTING GRAVEL
NEW OPERATIONS AND MAINTENANCE
BUILDING5394 SF
BUILDING NUMBER 5
PARKING - 5 SPACES
PARKING - 6 SPACES
MONUMENT SIGN (FUTURE)
ASPHALT PAVEMENT
SE
TB
AC
K
10
0'-0
"
60
' -0"
R/W
17
' -6"
ASPHALT PAVEMENT
EXISTING GRAVEL
ENTERPRISE PRODUCTS
10197 West County Road 1000N
Seymour, IN 47274
New Seymour Ops Building
Project Number (AFE): A43545
ENTERPRISE PRODUCTS - SEYMOUR IN OFFICE
0.1 SITE PLAN11/15/19
NORTH
PLAN
1
A
_____D3.1
2
_____D3.1
1
_____D3.2
2
2 4
92'-4"
26'-2 1/4" 21'-6" 21'-6" 21'-6"
3
B
4'-6
"
95 SF
101
VESTIBULE-1
79 SF
112
UNISEX
280 SF
110
MEN'S
317 SF
IDFROOM
109
528 SF
CONTROLROOM
108
112 SF
VESTIBULE-2
107
676 SF
102
TRAINING ROOM
293 SF
BREAKAREA
104
5
408 SF
WORKSTATIONS/STORAGE
105
202 SF
OPSSUPERVISOR
OFF
106
234 SF
CORRIDOR
113
1482 SF
MAINTENANCESHOP
113
8
6
9
10
5
4
1
3
2
7
55
'-1
0"
11
ENTRY
OUTSIDE TO OUTSIDE OF GIRT
93'-0"
OU
TS
IDE
TO
OU
TS
IDE
OF
GIR
T
58
'-0
"6
27
'-1
1"
27
'-1
1"
12
13
14
15
16
17
18
FUTURE
19
21
22
20
1' 1'
10
10
37 SF
JANITOR'S
111
70 SF
MECH
103
23
24
25
137 SF
CORRIDOR
114
ENTERPRISE PRODUCTS
10197 West County Road 1000N
Seymour, IN 47274
New Seymour Ops Building
Project Number (AFE): A43545
ENTERPRISE PRODUCTS - SEYMOUR IN OFFICE
D1.1 FIRST FLOOR PLAN11/15/19
0 4 8 16
NORTH
PLAN
LEGEND
1 MEN'S LOCKER - 18"X14"X72"
1' ADA MEN'S LOCKER -18"X14"X72"
2 BENCH
3 WOMEN'S LOCKER - 18"X14"X72"
4 LAUNDRY LOCKER
5 LARGE SCREEN
6 VENDING MACHINE
7 ICE MACHINE
8 PHOTOCOPIER
9 REFRIGERATOR
10 METAL CABINETS - 36"X12"X72"
11 COUNTERTOP FOR UPSDELIVERY
12 IT EQUIPMENT
13 UTILITY PANEL
14 SECURITY PANEL
15 MAIN PANEL
16 GENERATOR BATTERYCHARGER
17 UPS BYPASS SWITCH & XFMR
18 UPS PANEL
19 FIRE ALARM PANEL
20 GRAPHIC/ALARM SCREEN
21 DRAWING TABLE
22 APPROXIMATE AREA FOR HVAC
23 COUNTERTOP - (2) BASE ANDWALL CABINETS
24 COUNTERTOP - (4) BASECABINETS BELOW
25 COUNTERTOP - (5) BASE ANDWALL CABINETS
FIRST FLOOR0"
T/EAVE14' - 0"
124 35
FIRST FLOOR0"
T/EAVE14' - 0"
A B
3" / 1'-0"3" / 1'-0"
6
ENTERPRISE PRODUCTS
10197 West County Road 1000N
Seymour, IN 47274
New Seymour Ops Building
Project Number (AFE): A43545
ENTERPRISE PRODUCTS - SEYMOUR IN OFFICE
D3.1 ELEVATIONS11/15/19
SCALE: 1/8" = 1'-0"2
NORTH ELEVATION
SCALE: 1/8" = 1'-0"1
WEST ELEVATION
FIRST FLOOR0"
T/EAVE14' - 0"
AB 6
3" / 1'-0" 3" / 1'-0"
FIRST FLOOR0"
T/EAVE14' - 0"
1 2 43 5
ENTERPRISE PRODUCTS
10197 West County Road 1000N
Seymour, IN 47274
New Seymour Ops Building
Project Number (AFE): A43545
ENTERPRISE PRODUCTS - SEYMOUR IN OFFICE
D3.2 ELEVATIONS11/15/19
SCALE: 1/8" = 1'-0"1
EAST ELEVATION
SCALE: 1/8" = 1'-0"2
SOUTH ELEVATION
Industrial Districts Chapter 7
Jackson County, IN 7-1
Chapter 7
Industrial Districts
Section 7-1 Intent
Industrial District: The Industrial (I) District is established to include existing facilities and areas that are best suited for future industrial use due to accessibility and location.
Section 7-2 Uses
Use and development of land and structures shall only be for the following specified uses, unless Special Exception approval is granted. Uses are grouped into major categories and only those uses listed under each category are permitted. Land and/or structures in the district referenced at the top of the table may be used for the purposes donated by the following abbreviations:
P: Permitted- Land and/or structures in this district may be used for the purposes listed on the given chart.
S: Special Exception- Land and/or structures in this district may be used for the purposes listed on the given chart with Special Exception approval. All applicable standards cited in Chapter 14 Special Exception Review Requirements and procedures and Specific Requirements in Chapter 8 must be met unless a Variance is granted.
Use P/S RequirementsResidential Single-family dwellings PTwo-family dwellings SMobile homes & Manufactured dwellings on individual lots PTemporary Occupations SAccessory dwellings PLow impact home occupations PAgricultural, Forestry, Fishing & HuntingBait Sales SCommercial Greenhouse, Nursery, & Floriculture production SFarm sales & services SFarms (general) SFarms Confined Feeding SKeeping of Livestock & other animals (Non CAFO) SKennels SLiquid Fertilizer storage SRiding StablesRoadside produce sales SSales barn for livestock resale SSaw Mill & Lumber Yards SSeasonal Farm Employee Housing SSeasonal Hunting & Fishing Housing SSlaughter House, Locker, Cold Storage (Commercial) SGrain Storage (Commercial) SWineries, Breweries, Taverns SWholesale produce terminal SBusiness (Sales & Services)Bakery SBarber/Beauty Salon SBusiness or Professional Office SClothing Services SElectric Appliance Service & Sales SFood Sales & Services (Restaurants, Bakeries, Markets, etc.) SPet Shops (Retail, Grooming, Supplies) SPhotographic Studio SRetail Sales SWholesale Business SSexually Oriented Businesses SSimilar Uses SAuto Dealers, Service, Parts Motorized Vehicle sales/service/parts SLodging Accommodation Boarding SBed & Breakfast SElderly Living/Nursing Home SHotels/Motels SMobile Home Park SPlanned Residential Development SRecreational Camps & Public Camp Grounds STechnical Services/TowersCellular Towers SRadio Towers SWireless Communication Facilities, Tower, and Services SHealth Care & Social AssistanceChild care facilities SVeterinary clinics SRecreational EntertainmentCountry Clubs SGolf Courses SArtificial Lake (Under 3 Acres) SRace Tracks SShooting Ranges (Indoor) SShooting Ranges (Outdoor) S
Table Schedule of Permitted Uses
Industrial
S
8-1 (1)8-1 (2)
8-2 (1)
8-2 (2)
8-2 (3)8-2 (4)
8-2 (5)8-2 (6)
8-2 (7)
8-2 (8)
8-3
8-3 (1)
8-3 (2)
8-4 8-4 (1)
8-5
8-5 (1)8-6
8-6 (1)8-6 (1) 8-6 (1)
8-1 (3)8-1 (4)
8-2
8-1
Stadiums/Coliseum/Athletic Fields SSwimming Pools (Commercial) S 10-3Swimming Pools (Residential) PTheater (Indoor/Outdoor) SReligious, Civic, Social OrganizationsAssembly Halls SCharitable Institutions SChurches, and similar places of worship SConvention centers & halls SLodges & Private Clubs SCemetery & Crematory SEducational ServicesSchool Buildings (public, private, & parochial) SLibraries & Museums SVocational & Trade Schools SUniversity & College Buildings SPublic Administration Executive, Legislative, & Other General Gov. Buildings SPublic Safety Buildings SPenal Institution (Correctional & Juvenile Facilities) STransportationAirports/Heliports SUtilities & Waste Disposal Commercial & Waste Disposal SCommercial composting facilities SSanitary landfills SSewage Disposal & Treatment Facilities SWater Treatment Facilities SConstructionAsphalt, Concrete, and Gravel Plants & Storage SConstruction Offices, Showrooms, & Storage Yards SIndustrial Industry (General) SIndustrial Park SJunk Yard STruck Freight Terminal SSignsAdvertising Sign or Billboard (over 36.00' sq. ft.) S
Signs under 36.00' sq. ft. P
10-3
8-7
8-7 (1)8-7 (2)
12-112-2
8-8 (1)8-8
12
Industrial Districts Chapter 7
Jackson County, IN 7-4
Section 7-3 Lot Requirements
All lots shall meet the following minimum area and width requirements. No new lots shall be created or altered in a means that does not comply with the following requirements as referenced below.
Lot Area & Width Requirements
District Min. Lot Area Min. Lot Width Industrial 2 Acres (87,120 sq. ft.) 200.00’
* Note: All lots shall also require approval of two (2) approved septic sites or one (1) repairable system by the Jackson County Health Department.
A- Non-Conforming Lots of Record: New residential or commercial structures to be erected prior to the passage of the original Jackson County Zoning Ordinance, on lots of record which are smaller in area than the prescribed minimums of the table above, may be issued a building permit, contingent on the approval of two (2) approved septic sites or one (1) repairable system by the Jackson County Health Department.
B- Subdivision of Land: All divisions to land shall be subject to the requirements set forth in the Jackson County Subdivision Control Ordinance.
C- Access: 50.00' deeded access required on all residential building lots.
Section 7-4 Height Requirements
Any structure over the maximum height requirements referenced below must receive variance approval.
Maximum Height Requirements
Residential & Lake Residential Districts 35’
Agricultural & Forest & Rec. Districts 35’
Business Districts 45’
Industrial Districts 75’
Industrial Districts Chapter 7
Jackson County, IN 7-5
Section 7-5 Building Setback Requirements All structures shall be subject to the dimensional regulations set forth by this ordinance and referenced in the following table & charts.
Building Dimensional Requirements
Districts Front SB County Rd.
Front SB State Rd. Side SB Rear SB
One Story Dwelling (sq. ft.)
Two or more Story
Dwelling (sq. ft.)
Industrial 100.00’ 200.00’ 50’ 50’ - -
A- Accessory Structure: See Chapter 10 for setbacks and restrictions applicable toAccessory Structures.
B- County Regulated Drains: A minimum Setback of 75.00' (top of bank) shall bemaintained from the top of adjacent bank of a county regulated drain.
C- Corner Lots- Corner lots shall meet the minimum setback requirements from both roadfrontages.
D- Road Setbacks: The road or front yard setback shall be measured from the Centerline ofCounty & State Roads.
E- Height Requirements: Any structure greater than 300.00’ requires a Variance throughthe Board of Zoning Appeals, as well as any required documentation Federal AviationAuthority.
Jackson County Building Commission Permit Number Courthouse Annex Brownstown, IN. Conner Barnette – 812.358.6108
Applicant Last Name Applicant First Name
Applicant Address Applicant City Applicant State Applicant Zip
Applicant Phone Applicant Work Phone Applicant Cell Phone
Owner Last Name Owner First name
Owner Address Owner City Owner State Owner Zip
Owner Phone Owner Work Phone Owner Cell Phone
Directions Permit Fee
Double Fee
Other Fee
Restrictions Total Fee
Expiration Date
Sep. Permit
Location Address Location City Location State Location Zip Issue Date
Work Class
Subdivision Lot Contractor Name Use Type
County Zone
Front Setback Lot Width Lot Depth Building Area
Left Side Setback Building Dim Height Section/Township/Range
Right Side Setback Building Dim Width Garage Dim Width Township
Rear Side Setback Building Dim Length Garage Dim Length Acres
Other Improvements Zoned Flood
Drive Permit No.
The undersigned hereby certifies that the statements and drawings submitted are true and correct agrees to perform the work covered by this permit in the conformity with the laws regulations and ordinances applicable; comply with and conform to the deed & plat restrictions for the lot named herein.
______________________________ If any changes or deviations are made from the original application a new permit is required Owner’s Signature
Approved: __________________________________ ______________________________ Date
__________________________________ Planning Coordinator
No Yes