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Improvement Location Permit, Multifamily, Commercial, Industrial

  1. The Town of Zionsville, Indiana
    1100 West Oak Street, Zionsville, Indiana 46077
    Application for Improvement Location Permit, Multifamily, Commercial, Industrial
  2. Site Information:
      1. Applicant (Builder-Contractor)
      2. Property Owner
      3. Project Information
      4. Use:
      5. Type of Construction:
      6. Road Impact Calculation Sheet:
      7. Set Backs
      8. Floodplain Data
        (To be completed only if the site is within a 100 year flood plain)
      9. An elevation certificate signed by a land surveyor, engineer or architect is required if the site is located in a flood plain
      10. Lead Based Paint
        Per the Indiana Administrative Code 4101AC 32 and U.S. Code of Federal Regulation 40 CFR I acknowledge that have reviewed and if necessary have submitted all necessary information to the Indiana State Department of Health regarding lead based paint that presently exists in this structure.
      11. Fire Department Information – Fire Suppression / Fire Alarm Systems
      12. Fire Alarm System included in this project:
      13. Fire Alarm Suppression Systems included in this project:
      14. If your project or the project area contains a Fire Alarm, Sprinkler System, Kitchen Hood System or any other Special Hazard System, please contact the Fire Marshal at 317-873-5358.
      15. Signature*
        The undersigned hereby certifies that the above information is true and correct as (s)he is informed and believes and agrees, that as a condition of making this application and of its issuance, to conform to the building code of the Town of Zionsville and all instructions and directions of the Building Commissioner and Inspectors and further that the improvements authorized by this permit will not be used or occupied until a certificate of occupancy has been issued by the Town of Zionsville, Indiana.
      16. Road Impact Fee Estimate Request
        In addition to information identified on the project site plan, the Town of Zionsville requests the following supplemental information for purposes of calculating a Road Impact Fee estimate for the project referenced below. If any of the Project Information below is modified or changed, the impact fee may be adjusted to reflect the change.
      17. Location of Proposed Activity:
      18. Owner of the Premises Where Proposed Activity Will Take Place:
      19. Project Information:
      20. Identify any existing or proposed land uses or any expansion of existing usages. (Please be specific).
      21. Indicate the acreage of the entire project site and the square footage of all existing and proposed buildings and structures. Specify square footage dedicated to individual activities within the site/buildings. You may use the back of this sheet to illustrate.
      22. Indicate the total number of employees to be located at the proposed site. Include existing and future employees.
      23. List the hours of general operation, including anticipated deliveries or other site support services.
      24. Indicate the total number of on-site parking spaces intended for use by employees, customers, and deliveries.
      25. Indicate the average number of deliveries made to or from the proposed site in a 24 hour period.
      26. Indicate the existence and capacities of any on-site food services or vending facilities that enable employees or visitors to prepare and eat meals on-site.
      27. Indicate the number of and identify all businesses or facilities adjoining the proposed site.
      28. Certification:*
        I hereby certify that I have the authority to make the forgoing application and that the application and accompanying site plan are correct.
      29. Leave This Blank:

      30. This field is not part of the form submission.