Fillable PLANNING DEPARTMENT BUILDING PERMIT APPLICATION FOR MULTI-FAMILY, COMMERCIAL,

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PLANNING DEPARTMENT BUILDING PERMIT APPLICATION FOR MULTI-FAMILY, COMMERCIAL,

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PROJECT LOCATION INFORMATION
Site Address:
Parcel ID:
Lot:
Subdivision
Section No.
Subdivision:
PROJECT DETAILS
Parcel Size (acres):
Impervious Area (sq. ft.):
Earthwork/Land Disturbance (acres):
Brief Description or Purpose of Project:
Existing Site Use:
Description of surrounding properties:
Project Start Date:
Completion Date:
PERMIT NUMBER:
DISCLAIMER: This application does not include
or incorporate a sign application or approval.
Date Stamp
Office Use Only
Email:
Name:
OWNER INFORMATION
Mailing Address:
City:
Phone:
Fax:
Contact Name:
PROPERTY USE
Residential, Multi-Family
Commercial
Industrial
Government
School
Institutional
Public Works (Capital Project)
Moving
Remodel/Tenant Finish
Foundation Only
Demolition
Addition:
New Structure:
Mailing Address:
Email:
Fax:
Phone:
Zip:State:
City:
Contact Name:
Business Name:
TYPE OF STRUCTURE IMPROVEMENT
Reinforced Concrete
Other
Structural Steel
Masonry (wall bearing)
Square Footage
Square Footage
UTILITIES INFORMATION
Public Individual Well
Type of Water Supply:
Public
OtherType of Sewer Disposal:
Oil
GasType of Heating:
Electric
None
Central-Gas
Central- Electric
Type of Air
Conditioning:
Individual Window Units
Structure:
Land:
Valuation of Project:
Propane
PRINCIPAL
TYPE OF
FRAME
Accessory Structure:
Zip:
State:
BUILDING PERMIT APPLICATION
FOR MULTI-FAMILY, COMMERCIAL, INDUSTRIAL,
GOVERNMENTAL OR INSTITUTIONAL STRUCTURES
16 S. 10th Street, Suite 150 Noblesville, IN 46060
phone: 317-776-6325
www.cityofnoblesville.org/planning
PLANNING DEPARTMENT
Square Footage
Other:
Wood
Prior Use:
CONTRACTOR INFORMATION
Common Name:
Square Footage
Proposed Use:
Page 1 of 2
I hereby certify that I have the authority to make the foregoing application, that the application is correct, and that the
construction will conform to the regulations in the Building Code, the Unified Development Ordinance, Noblesville
Construction Standards, the Stormwater Ordinances and Stormwater Standards Manual, the approved Plans and
Specifications, IDEM requirements, any and all Local, County, and State requirements including private restrictions, if
any, which may be imposed on the above described property.
I further certify the modifications to the site and erection of a structure to be completed with this project will not cause
any adverse drainage condition that would cause damage to adjoining public or private property as a result of this
construction.
I understand that I have six (6) months to request my first building inspection, and no more than two (2) years to
complete this project. If I do not begin or finish within the allowable time, this permit will be null and void.
I further understand that all work associated with the issuance of this permit must be inspected and approved by the
City of Noblesville, at predetermined points in the construction process, and includes inspections by both the Planning
and Engineering Departments.
I further certify that the construction for which this permit is issued will not be used or occupied until proper Certificates
of Occupancy are issued by the Department of Planning and Development.
CERTIFICATION & NOTICE OF INTENT TO COMPLY STATEMENT
Signature of Owner or Authorized Agent:
Printed Name:
Email:
Phone:
Width
Length
Number of
Spaces
Length
Woodland Area
REMOVED:
Acres
Disturbed
Fax:
City: State:
Zip:
Mailing Address:
Contact Name:
Business Name:
Length
STORM SEWER:
Extension
Connection Repair
New Repair
Length
SANITARY SEWER, SERVICE CONNECTION:
Intercepter
SANITARY SEWER, MAIN EXTENSION
Length
ENGINEER OR LAND SURVEYOR INFORMATION
FINANCIALLY RESPONSIBLE PARTY
Person to be billed for all
expenses relating to permit:
TYPE OF SITE IMPROVEMENT
DRIVEWAY:
Reconstruction
RepairNew
ADA Curb Ramp
Repair
SIDEWALK:
Length
Width
Parking
Lot
New
Repair
Width Length
New
Length
ROAD (PUBLIC):
Width
Water Main Extension
Does the property contain a floodplain?
Does the property contain any wetlands?
YES NO
YES NO
Page 2 of 2
MODIFIED 09-24-2014
SEA 393 DISCLOSURE
In
accordance with Senate Enrolled Act No. 393 (SEA 393) regulations, all Class 1 structures must disclose the
types of advanced structural components used in the qualifying property.
Advanced Structural Components Used:
(check all that apply)
Roof (specify below)
Truss
I-Joist
Other: ____________________
Floor (specify below)
Truss
I-Joist
Other: ____________________
Township of Project:
County of Project:
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PLANNING DEPARTMENT BUILDING PERMIT APPLICATION FOR MULTI-FAMILY, COMMERCIAL,

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Completed 14 October 2021

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