HomeMy WebLinkAbout05120056-Application Clay TownsMl~ Permit #
RESIDENTIAL IMPROVEMENT LOCATION PE APPLiCATiON
For Single Family, Hulti-Family, & Two Family: New Structures, AddiUons, Remodels, & Accessory Structures
BUILDER'S EMAIL ADDRESS
PROPERTY
OWnE.:
STEEET ADDRESS CITY
LOCATION
& PROJECT
ZNFO:
SUBDMSION NM4E
ZONING:
NUHBERS; TAC DA'[E(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMH' #'S (IF APPL]CABLE): ~ (~ ~
~ SINGLE FAMILY
[] TOWN HOME
[] TWO FAMILY
# of units:
[] MUm-FAMILY
# of Units:
RESIDENTIAL (For
Additions, Remodels, Etc.)
Early Release
Permit: Y~N
Lot Split: N
P Ft' V M NT:
~IEW STRUCTURE
~ ROOM ADDITION(S)
[] PORCH ADDITION(S)
[] REMODEL
[] ACCESSORY BUILDING
[] A1-FACH
Manufactured
Trusses:
Sump Pump: ~y__N
Does any part of the proPerty lie within a special Flood designation;
P UF,IBT G 0NTRA :
Plumber's Indiana Sta~e ~nse #:
Which plumbing codes will be applied to the cons~ruction:
~Tntemational Residential Code w/Zndiana Amendments
t apply for the new
POST & BEAM
__Y WALKOUT:_____Y~
OFF~CE USE
80 da-- - can-dLT~°~ F ~.' y dwellk~ g,s, a,d~ti,'.ons, rem.odels,,and/or accessory structures, this permit is valid only ff co~seruction commences
gssuance date. y~v~L"~ate~i~suan~e~n~u~eang~errmt~anamu~tb~c~mP~t~d(~ert~icat~f~ccu~an~yissued)w~thin~8m~nths~the
Class I structure permits are subject to the General Administrative Rules of the State of Indiana (See 675 IAC 12) regarding expiration
tLme frames for beginning and completing construction.
I, the undersigned, agree that any construction, reconstruction, ezflaxgement, relocation, or akexation of a structure or an chane in the use of
stmctures requested by this application wLll com~lv with andc~f~ -n~- ~* ~, ....... ' y g andor
~a~ua - iy~a ta~z~) aha amenoments, aaopteo under authority of LC. 36-7 et ten G~rle~ Assembly of the e ..... c ,-a .... g.. . armel
thereto. I further cert~ that on]y kitchen, bath, and J~oor drains are connected to the saxMta~ sewer. I further certify that the construction will not be
Filing Fees:
'
~ ~ ...... Cert. of Occupancy: , ~() Reviews
'~ ~ ...... ~ P.R.LF.: ~ ~ Additional Fees
/ 0~
Reviewed/Approved: Dept. of Community Services (Date)