BUILDING PERMIT APPLICATION
Brule County Building
300 S. Courtland St. Ste.101 Receipt No.____________________________
Chamberlain, SD 57325
Fee Paid $____________________________
Please attach a list of the names, addresses, and telephone numbers of all other contractors and subcontractors
on a seperate sheet of paper.
Class of Work: _____New
No. of Stories:__________
Size of Lot:_______________
Signs, If permitted Proposed
Use of Structure:
Type of Construction:(e.g. wood, brick, etc.) No. Off-Street
Attach to this application a scale drawing of the shape and dimensions of the location of streets
and alleys: all existing and proposed buildings and distances from buildings to lot lines; an proposed and existing off street
Note: This application is not acceptable unless all required information is furnished and accurate.
Every permit issued by the Zoning Official under the provisions of this code shall expire by limitation and become null and
void if the building or work authorized by such permit is not commend within 90 days from the date of such permit, or if
the building or work authorized by such permit is not completed within one year from issuance of permit.
Approval of this building permit should not and shall not be construed as an approval of the endorsement or
ability of the contractors involved, the suitability for the proposed use of the plans submitted, the fitness of the proposed
location of the construction, the ownership of the land shown, a right to change water drainage in any manner or to grant
any other right to authority except as is authorized by the Brule County Zoning Ordinance.
The above information is, to the best if my knowledge, true and accurate. It is understood and agreed that
any error, misstatement of misrepresentation of fact, either with or without intention on my part such as might, if known,
cause a refusal of the application, or any alteration or change in plans made without the sufficient grounds for the renovation
of such permit.
(Owner or Contractor)