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Irrigation Contractor Registration (Official PDF)

Building Department · St. Joseph County, Indiana

Editable official PDF

Edit the agency’s original form, save your draft, attach documents, and review your completed PDF before signing or ordering delivery.

Print and mail service is available for your prepared packet. Review the destination and the agency’s acceptance requirements before ordering. Government payment is separate from document and postage charges.

Applicant inputs are mapped directly on the official agency PDF. Agency receipt and professional certification fields remain reserved.

Official form and instructions
Your application steps6 steps · Building DepartmentView steps
  1. 1Prepare your answersComplete here

    Edit and save your answers on the official PDF.

    Official source
  2. 2Add supporting documentsComplete here

    Attach the supporting records listed by the agency. Check that every page is legible and complete.

    • Include all supporting documents and plans listed on the official PDF checklist.
    • The agency reviews the completed application before issuing a permit or license.
    • Provide the original signed surety bond or continuation certificate required by the registration instructions. A printed copy does not replace a required original.
    • Complete the sworn declaration with a notary; leave notary fields for the notary to complete.
  3. 3Review and signPrepare here, finish outside

    Complete each applicable applicant signature after reviewing the full declarations. Required notary, professional and witness signatures remain separate.

  4. 4Choose paymentPrepare here, finish outside

    $125 annual registration fee; confirm any arrears or additional fees with the Building Department. Government fees are separate from the optional prepared PDF and postage. Review the exact amount and recipient before authorizing a check.

  5. 5Submit or order deliveryPrepare here, finish outside

    Submit this official application and all required supporting documents to the Building Department by mail or email. Fees are assessed separately under the current schedule; keep the application and payment reference together. Complete the notarial act and supply required originals before delivery. Confirm the exact fee and check payee with the department before ordering a separate government-fee payment.

    Official submission instructions
  6. 6Keep your receiptComplete here

    Save your agency confirmation and payment receipt. Track any mailing from My applications. Delivery does not mean the agency approved your application.

Official requirements and sources

Complete your application

Required fields are marked *. Fields follow the agency’s published form. Save your work before leaving this page.

Fill in the official form

Select a highlighted blank and type directly. Use Field list for larger controls and any answers that need a continuation page.

Page 1 of 3 · 16 editable blanks
PAYMENT: CHECK # CARD *WE DO NOT ACCEPT AMERICAN EXPRESS CASH *EXACT PAYMENT MAY BE REQUIRED IF WE ARE UNABLE TO MAKE CHANGE FOR CASH PAYMENTS cpalafox@southbendin.gov APPLICATION FOR CONTRACTORS COMPANY NAME: E-MAIL: ADDRESS: TELEPHONE NUMBER: PRESIDENT/LICENSE HOLDER: BUSINESS ASSOCIATION (check one): Limited Liability Company (LLC) Sole Proprietorship General Partnership Corporation S-Corporation Nonprofit Corporation Limited Liability Partnership (LLP) Limited Partnership Other: I, BEING DULY SWORN UNDER OATH, DEPOSE and say that all the statements in this application herewithin are true. I will be responsible for compliance with all ordinances and laws in effect governing work performed under building permits issued by the St. Joseph County/City of South Bend Building Department. Signature of Applicant Subscribed and Sworn to before me this day of Signature of Notary My Commission Expires: Resident of County ADDITIONAL INFORMATION REQUEST As an ongoing effort to better serve the community, please take a minute to indicate if you are a member of one of the groups listed on the following page. Please note that refusing or failing to self-identify into one of these categories cannot be grounds to deny a registration request. Applications cannot be approved or denied on the basis of whether a contractor’s business does or does not fall within one of these categories. (See questionnaire on page 3.) EXCELLENCE I ACCOUNTABILITY I INNOVATION I INCLUSION I EMPOWERMENT 215 S. Martin Luther King Jr. Blvd. | Suite 100 | South Bend, IN 46601 | p. 574.235.9554 | f. 1 574.235.5541 | www.southbendin.gov

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Review every page before signing. Professional, agency and notary signature areas stay reserved.Original blank form