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HomeMy WebLinkAbout05120005-Application IMPROVEMENT LOCATION PERMIT APPLICATION MulU-Family, & Two Family: New Structures, AddiUons, Remodels, & Accessory Structures --~'OPERTY OWNER: LOCATION & PRO3ECT INFO: SEWER U~LITY PROVIDER: BUILDER'S EMAIL ADORESS ~ , / . BEST ME'ITt~C OF CO~ACT,~..~ ~ LOT # SUBDMSION NA~E i [ ~ / ADDRESS OF CONSTRUCTION PROVIDER: (~ ~ /~ ~,'~ ~_.~..__ ~ BZA / BPW DOQ(E'r iF APPLICABLE): SECT[ON ZONING: SQUARE FOOTaGe: (EXCLUDING LAND VALUE) 'O ~ ~- 0 6~ E3 TOWN 0 ~'\0 I #of [] f BUILDING #of O RESIDENTIAL (I ATTACHED GARAGE [] DEMOLITION Early Release / Trusses: Manufactured Sump Pump: Y d.d_N Does any part of the property lie within a special Flood designation area: : of issuance of the issuance date. Class I structure permits are subject to the Plu~s ~ndiana State License #: Which plumbing cod~s will be applied t~ the construction: ~mational Residential Code w/*rndiana Amendments [] Uniform Plumbing Code w/indiana Amendments (Multi-Family Construddon Code) ~[~L~: (Check all that apply for the new construction area) [] BASEMENT :xpiration :i~ rheuseof landor oroved: ~nib/Servia, (Date) RESIDENTIAL I, thc undersigned, agree char any construction [ Indiana, and thc 'Zoning Ordinance of Camel structures z~tuested by this application will comply wid~ ~1.11 A re nme~rlaror~ 'n~ana - 1993- (Z.289) and amen .~. ~. ts, adopted uncler a ........ ~lereto. I further cextify that only kitchen, bath, and floor drains are connected to the samtary sewer. I mrrllcr, ccrrlly that, mc,c. onsrrucuon wm nu~ 'ed or occupied unti~ a· Cert:ffica f Occupanc?has been issued by the Department of Community Serrates, Carmet, Inmana. xCF USE ONLY: ************************************** Rlin9 Fees: Base InspecUons: # Char§ed Re R~tiew$ Cert. of Occupancy: P.R.I.F.: // ~ Additional Fees