ABC County Planning

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APPLICATION FOR
IMPROVEMENT LOCATION PERMIT AND CERTIFICATE OF OCCUPANCY
COUNTY OF JASPER
Applicant Details
Name of Applicant
Phone
Email
Address
City
State
Zip
Name and Address of Landowner
Location:
Section
Township
Range
Lot
Block.
Subd. or Add.
Located on County Road
Twp.
Zone
Paid $
Receipt No
Sewage Permit
Well Permit No

* Please have your plan ready as PDF before filling this application.

LOT Width (ft.)
LOT Depth (ft.)
LOT Area (Sq. ft.)
BUILDING Width (ft.)
BUILDING Depth (ft.)
BUILDING Living Area (Sq. ft.)
Certificate of Occupancy Issued (mm-dd-yyyy)
Set Back (ft.)
Flood Plain
The undersigned agrees that any construction, reconstruction, enlargement, relocation or alteration of structures, or any change in use of land or structures requested by this application will comply with and conform to all applicable laws of the State of Indiana and Ordinances of the County of Jasper, Indiana, adopted under the authority of Chapter 174 of the Acts of 1947, General Assembly of the State of Indiana, and all acts amendatory thereto.
The undersigned further agrees that the issuance of an improvement location permit and / or a certificate of occupancy in no way validates such a permit or certificate in the event that same is erroneously issued or does not comply with applicable laws and ordinances. The undersigned further agrees that the issuance of an improvement location permit and / or certificate of occupancy in no way permits the violation of any restrictive covenants relative to the real estate.

Signed By:
Remarks
For Office Use Only

No

Taken By

Date (mm-dd-yyyy)
Attach Document (PDF, JPG, PNG, GIF, TIFF Only)


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