Kosciusko County, Indiana

The homepage for the government of Kosciusko County, Indiana

Contractor Enrollment Form

 Step 1 of 1

Builders complete this form to enroll with Kosciusko County. Enrollment is valid from January 1st to December 31st of each year.

* Denotes a required field

Your Information

*
*
*
*
Zip Code*
-
Second portion of ZIP Code is optional.
Applicant Telephone: 
-- ext
Applicant Cell Phone: 
-- ext
 
Applicant Fax Number: 
-- ext
 

Other Information

Complete this section if the information is different from the above.
 
 
 
 
Contractor Zip Code 
-
Second portion of ZIP Code is optional.
Contractor Telephone: 
-- ext
Contractor Cell Phone: 
-- ext
Contractor Fax Number: 
-- ext
 
By signing this form you are stating 'I certify with my signature below that I will comply with all provisions of the State of Indiana Building Codes'.
*
*
Today's Date:*
 Today's Date:
This form will be kept on file in the Kosciusko County Area Plan Commission Office and must be renewed each year.
*