Name / Mailing Address

COMMERCIAL BUILDING PERMIT APPLICATION COMPLETE ALL EXCEPT SHADED AREAS

OWNER Name (MUST BE SAME AS DEED) / Mailing Address Date: Ctrl # ______Applicant/Contact Name:

Phone #: Cell / Office/ Home

Email Address:

PROPERTY ADDRESS: Part of TL REG SEWER DIST?  YES  NO

Current Property Use: Proposed Property Use:

BUILDER Name / Mailing Address Estimated Value of Project: $

Parking Lot Addition or Changes?  YES  NO

B & P NOTES:

Builder Phone: Builder #:______

Structure Width Length Total # Of Height Basement? FEE Sq Ft Stories to (Full, Partial, Peak None) / / / / / / / /

TOTAL FEE:

I have attached the following items as required by the permit application (See "Information Needed For a Commercial Building Permit"):

REQUIRED FOR ALL Other Items (if applicable) For Foundation Release Copy of State Release (CDR) - #______Mayoral Approval Copy of State Foundation Release Building Plans (as submitted to the State) Drainage Permit Verification Form Sewer or Septic Permit Site Plan DNR (Flood) Permit Construction Drawings Health Dept Approval Property Record Card TLRSD Dept Approval Parking Lot Site Plan

PROCEED TO PAGE 2 - INITIAL, DATE, AND SIGN WHERE INDICATED

******WHITE COUNTY USE ONLY BELOW THIS LINE******

New Address Req'd? ____Ag/Ops Req'd? ____

FLOOD ZONE? SURVEYOR'S OFFICE Zoning ______ILP # ______Exp Date ______

Setback Requirements - House/Accessory/Deck: Y / N (Not required if Approval Letter Rec'd)  Side: ______/______/______Sum: ______Panel #: ______Regulated Drain: Drainage Board Front: ______/______/______Max Ht: ______DNR Approval? Elevation Assessment Yes ______Rear: ______/______/______Var #: ______No ______USE:

ADA/Parking Reqs: Drainage Permit NEW ADDRESS Surv Initials: Required? REQUIRED? AP Approval: ______

PLANS CHECKED BY: Date: NOTES:

COMMERCIAL BUILDING PERMIT APPLICATION - PAGE 2 Completed Form Must Accompany All Applications OR ABUTS AGRICULTURAL LAND1 OR A-2,IS ZONED A-PROPERTYIFREQUIRED DRIVEWAYSFOR NEWREQUIRED FOR ALLREQUIRED Print Name ______details. same. the understand and foregoing the only but appurtenances, its or operation agricultural an of operation are you notice this of receipt rezoning. for request to your prior of consideration law or permit Indiana improvement understand location County and White a of of aware issuance your are you that confirm to notice this you providing is County White machinery and livestock from noise and operations field from dust of creation operations. crops, growing and fields to pesticides of application land, to manure animal of to, application under livestock, limited of not feeding nuisance confined is livestock, but of grazing include, a may activity constitute Agricultural operated. not negligently not do are they as operations long so law Agricultural Indiana operations. agricultural existing with neighbors abutting by suits property nuisance public or private from operations agricultural protects 32-30-6-9 Code Indiana property abuttinganAgricultural District County. within White a rezone or develop to permit improvement location a for applied have you because notice this receiving are You ApplicantInitials: ______RoadDepartment (ifwithin townor city Whitethe Highwayor limits) County Department (219) 984-5851. If this constructionplacementincludes of a driveway, obtainyou must a driveway eitherfrompermit City/Townthe Print Name ______I acknowledgereceipt this document (mayof besigned by Owner,Agent). Builder,or of Board Area fine a the remove or before dependingdecrease, on evidence presented. increase, heard to right be the reserves to Appeals scheduled Zoning of be Board Area will The appeal Appeals. Zoning The Ordinance. Zoning County White the of ZoningOrdinance.If violatorthe wishes to contest thefine,the violator appeal asmust provided in for 13 Chapter County White the of 13 Chapter prescribedby violationas the abates or violation the corrects violator the whether place in remain will fine This fine. the to added be will month per $50.00 of fee late a established, frame time the within received not is payment If otherwise. made are payment Director Executive for the to days acceptable arrangements unless (30) thirty no given and be and $10.00 fine the than of less notice written no receive will of violator The fine immediate $300.00. than an more issue Executive may The Commission, Plan issued. Area been the has of citation behalf violation on zoning Director, civil a if applied be shall schedule fine following The below. investigation.civilviolation zoning understandthatzoning a I finesmaycivil violationresult as in shown notmeet application,should site or I plan,building etc., setbacks as shown my on maybe I tosubjecta my I building fromwhat project have should understand deviate buildingthat, in permit I submitted my TO: ALL DEVELOPMENTPERMITSTO: LOCATIONIMPROVEMENTSFOR REZONING APPLICANTS FOR OR OF they may change. The conversion of one type of agricultural to typeoperation ofone another ofchange. they The conversion may

agricultural areas that agricultural operations may be occurring nearby thatnearby beoccurring and agricultural operations agricultural may thatareas type of agricultural operation does not affect thedoes typeoperation statutory of not protections provided agricultural ______By initialing& am to ______I the I dating By acknowledging left, that home to a residence, a CFO/CAFO, digester or other intense agricultural intenseactivity aother or home residence,CFO/CAFO, digester to This notice advises persons choosing to develop or rezone a property rezonea abutting orproperty noticechoosing to persons develop advisesThis will be entitled to build on a parcel abutting or near you and is not required not to near isrequired beentitledparcelabutting or and you will a to build on Effective July 1, 2016, if you build a new residence on a parcel a parcel not on previously residencea build 2016, younew 1, if JulyEffective REQUIRES REQUIRES White County ofWhite Board Zoning Appeals Zoning -Civil - Revised 30,Violations April 2013 PROPERTIES ABUTTING AN AGRICULTURAL DISTRICT WITHIN WHITE COUNTY PROPERTIES WITHINWHITE AGRICULTURALABUTTINGDISTRICT AN keep those structures 1,320 feet away from your residence. feet from 1,320 your residence. keep structuresaway those OWNER understand and agree to to setbackand understandthe agree above exception. SIGNATURE – PLEASE TAKE THIS FORM TO OWNER FOR SIGNATURE PRIOR TO SUBMISSIONSIGNATURE OWNERFORMPRIOR PLEASE TO SIGNATURE TAKE THISTO FOR – not giving up the right to seek redress for a nuisance resulting from the negligent the from resulting nuisance a for redress seek to right the up giving not NOTICE OF AGRICULTURAL OPERATIONS OF NOTICE AGRICULTURAL WHITE COUNTY AREA AREA COUNTYPLANWHITE

Please review Indiana Code 32-30-6-9 in its entirety for further for entirety its in 32-30-6-9 Code Indiana review Please by32-30-6-9. IC

Signature Signature

confirming that you have been advised of advised been have you that confirming Date Date BP #: BP Revised 04/15/2016Revised By