CITY OF CARROLLTON 

 

(Execute in Duplicate) Application No. 

 

APPLICATION FOR BUILDING AND MANUFACTURED HOME OCCUPANCY PERMIT 

 

Office of the Mayor Application No. 

City Hall 

Carrollton, Illinois DATE: , 

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(DO NOT WRITE IN THIS SPACE - FOR OFFICE USE ONLY) 

 

DATE: , ___ PERM. PARCEL ______ ______ ______ ______ _ 

 

[ ] Permit Issued Fee Paid to City Clerk: 

[ ] Permit Denied 

[ ] Application Appealed $____________ DATE: 
________________________, 

 

 IF DENIED, CAUSE OF DENIAL: 

 

 

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INSTRUCTIONS TO APPLICANT: All information required by the application must be completed and 
submitted herewith. Applicants are encouraged to visit the City Hall for any assistance needed in 
completing this form. 

 

1. Name of Owner(s): 

 (Attach additional sheets if necessary) 

 Address: PHONE: 

 (ZIP CODE) 

2. Applicant’s Name: PHONE: 

 Address: 

 (ZIP CODE) 

3. Property interest of applicant: 

 (Contract Purchaser, Etc.) 

4. Address of proposed construction or manufactured home: 

 

5. Legal Description (Lot, Block, and Subdivision; attach metes and bounds description, if 
necessary). 

 

 

 Cost of Improvement: $ Square feet of Improvement 

6. Proposed construction (check one or more, as necessary): 

 [ ] New Building Type: Brick/Frame Number of Rooms 

 [ ] Alterations or additions to existing buildings (explain): 

 

7. Use of existing and proposed structures (if applicable): 

 Existing Use: 

 Proposed Use: 

8. Two (2) copies of a sketch plat (drawn to approximate scale shall be attached, showing the 
following: 

 a) Dimensions and use of all buildings; 

 b) Dimensions of lot; 


 c) Distance of each building from lot lines; 

 d) Distance of principal building from principal buildings on adjacent lot(s); 

 e) Distance between accessory buildings and principal buildings; 

 f) Distance from lot line to center line of abutting street(s); 

 g) Location [with dimensions] of driveways and off-street parking spaces; 

 h) Location of all easements; 

 i) Location of all underground utilities, including septic tanks, tile fields, and wells. 

9. Application is hereby made for an Occupancy Permit as required under the City Code for the 
erection, moving, or alteration and use of buildings and manufactured homes. In making this 
application, the applicant represents all of the above statements and any attached maps and 
drawings to be a true description of the proposed new or altered uses and/or buildings. The 
applicant agrees that the permit applied for, if granted, is issued on the representations made 
herein and that any permit issued may be revoked without notice on any breach of representation 
or conditions. (See Chapter 23) 

 

 It is understood that any permit issued on this application will not grant right of privilege to erect 
any structure or to use any premises described for any purpose or in any manner prohibited by the City 
Code, or by other ordinances, codes, or regulations of the City. 

 

 APPLICANT: 

 

 

CERTIFICATE OF OCCUPANCY 

 

The plans and specifications submitted with this Application are in conformity with the district 
requirements applicable to the subject property. Changes in plans or specifications shall not be made 
without written approval of the City Council. 

 

Failure to comply with the above shall constitute a violation of the provisions of the Revised Code of 
Ordinances of the City. 

 

DATE: , ___ 

 BUILDING OFFICIAL