HomeMy WebLinkAbout05120028-ApplicationCity of Camel~Clay Township ~
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, & Two Family: New Structures, AddiUons, Remodels, & Accessory Structures
BEST METHOD OF CONTACT:
PHONE FAX
CATY STATE ZIP
LOCATION
& PRO2ECT
ZNFO:
SUBDIVISION NAME 5EC~ON
ADDRESS OF CONSTRUC'~ON
SEWER IJTILtTY WATER UTIUTY
PROVIDER: (EXCLUDING I
EXCAVATION CONTRACTOR; PLAN COMMISSION ! BZA / BPW DOCKET
NUMBERS; TAC DATC-:(S); AND/OR COUNTY WELL AND/OR
ZONING:
O TOWN HOME
[::3 TWO FAMILY
# of units:
~ MULTI-FAMILY
# of Units:
{:~ RESIDENTIAL (For
Additions, Remodels, Etc.)
PRO.]-, - _ -:-.- --.:
ROOM ADDITION(S)
PORCH ADDITION(S)
[] ATTACHED GARAGE
[] DEMOLFFIO~
Uniform Plumbing Code w/Indiana Amendments
(MuRi-Family Const~uddon Code)
?- UNDAT[ N TYPE: (Check all that apply for the new
[]/POST & BEAM
I:~ BASEMENT
WALKOUT:
sewer. I further certify
Print --~ --
OFFICE USE ONLY' ***********************************************~************************
· Filing Fees:
Under Slab 5~T ~.~O Reviews
Cert. of Occupancy:
site~2
P.R.I.F.:o./~ AddiUon"al Fees
T · :_5~ ~
TO
· ,¢" ..<::. /7 <. ~.