Application Date:				Sidwell #				Township:
Property Address:
Property Owner:						Zoning:		Required Setbacks:
Owner Phone:						Flood Zone:		Front:		Rear:
Owner Email:						Property Size:		Sides

Project Type: Residential Commercial						Size of pond: Greater than 1,000 sq. ft: Yes No
Contractor:						Approx. Sq. Footage:
Contact Name:						Contact Number:
Job Description:
Primary Purpose of Pond:
Estimated Cost:

Required Documents:
Site Plan:		Scaled Drawing of pond:		Building Plan:

Office Use Only: Approvals & Comments

Building Commissioner:

Flood Plain Manager:

County Surveyor:

Highway Engineer:

Health Department:

Muncie Sanitary District; Stormwater Management:

Permit Cost:	Date Paid:	Receipt #:
	CH / CA / CC	Staff Initials: