ABC County Planning

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White County Building & Planning
Improvement Location Permit Application
(Revised 02/13/19)

Applicant Information
Applicant Name
Phone
Email
Address, City State, ZIP
ILP-Current Property use
Parcel Number
Date Filed (mm-dd-yyyy)
Estimated Value of Project $
Estimated Damage
Empty Lot:
Replacement
Damage Description
Owner's Name and Mailing Address

Owner Last Name

Owner First Name

Phone
Street
City
State
Zip
Zoning Section
District
Located in Flood Plain
Community Panel No
DNR EFARA#:
Structure Details
Type of Structure

Structure Size
Width

Length

Height to Peak
Minimum Setbacks
Lot Size
Side
Front
Rear
Max Height

Applicant must provide (if applicable):
Agriculture Sheet
Site Plan
Property Record Card
Other (as requested)
All ILP's must call for a final inspection to ensure compliance with the White County Zoning Ordinance and receive an official Certificate of Compliance.

I understand that failure to meet the requirements or deviations from what I have submitted as part of my application may be subject to a civil zoning violation investigation. I understand that a civil zoning violation may result in fines according to CH 13 of the White County Zoning Ordinance.

I acknowledge receipt of this information (may be signed by Owner, Builder, or Agent).

Print Name
Date Signed (mm-dd-yyyy)
Note: Improvements location permits for parking lot restriping are allowed a total of (2) renewals, at no charge, within a period of 3 years from the date of issuance of the original permit. This renewal applies to a current Improvement Location Permit for a parking lot where the extent of the new work is restricted to restriping only (regardless of the improvements covered by the original permit).

Area Plan Approval
Regulated Drain
Initials for Reg. Drain
Total Fee
Permit
Receipt Number
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