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HomeMy WebLinkAbout05110166-ApplicationO' "~-~ ~ Permit# SIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION For Single Family, Multi-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Structures RECORD: ~' ~ :;' / .- :.:- '~'~ 'f:; ~ 'J~'/~'' ~ _ STREET ADDRESS ; ..... -- ~ CfiDf STATE ZIP PHONE FAX --PE ON TR CT~ N: {~ SINGLE FAMILY C~ TOWN HOME [] TWO FAMILY # of un ts: , C3 MULTbFAM~L-~-~ # of Units: [] RESIDENTIAL (For Additions, Remodels, Etc.) TYPE :FIMPR VEMENT_: NEW STRUCTURE [] ROOM ADD~I~ON(S) PORCH ADDiTION(S) REMODEL [] ACCESSORY BUILDING [] ATTACH C] DEMOLITION SubPs . /Manufactured ,_, ~l,~ (~Jec~all that apply for the new Y N Trusses: Y~*~'~(W~ '~.~'~,/ ~?~), 1 ©W~',.c~f~tP / - ~ ~ ~CE ~ POST& B~M Lot Split. Y ~N Sump Pump. ~ ' N ~ S~B ~ ~ BASEM~ T ~ Does any pa~ of the pmpe~ lie within a special Flood designation area: Y~ WALKO~: Y ~ structures requested by th~ apphcadon ~ comply with, and confom to, ~ apphcable hws of the Stare of indiana ~d che Zo~ng Or~ce of C~md India - 1993' (Z-289) ~d amen&n~ts, adopted under authority of I.C. 36-7 er seq Gener~ Assembly of the State of indiana, and ~ Acts amendato~ ~ / OFfiCE ~E OffiLYl ************************************************************************ of Community Sen/ices Filing Fees; Base ~nspections: __~__~ = Char~ed Re- Reviews Cert. of Occupancy; P,R.LF.: ~ Additional Fees . , . . /) , /~TOTAL: INSPECT/ONS REQUIRED: Under Slab