HomeMy WebLinkAbout05120057-ApplicationRECORD:
PROPERTY
OWNER:
tarred/Clay Township 3 Permit #:
IMPROVEMENT LOCATION PERMIT APPLICATION
Family, Multi-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
PHONE
LOCATXON LOT # /~~ ~AM~, [-~, ~_/ ~a .o~L°T# · SUBDIVISI AME .~
&PROJECT ~ ~ ' /1: ~ ~
IN FO: ADDRESS OF CONSTRUCTION ' ~ .
SEWER u'r[LiTY MATED COS~T OF CONSTRUCTION:
PROVIDER: ~ ~LAN~
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOC~-r
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S
OF N:
TYPE FZ~~:
~ SINGLE FAMILY
L~ TOWN HOME
gNEW STRUCTURE
ROOM ADDITION(S)
[] TWO FAMILY [] PORCH ADDITION(S)
# of units: [] REMODEL
[] MULTI-FAMILY [] ACCESSORY BUILDING
# of Units:. [] DETACHED GARAGE
[] RESIDENTIAL (For [] AI-FACHED GARAGE
Additions, Remodels, Etc.) [] DEMOLITION
untematJonal Residential Code w/Indiana Amendments
iform Plumbing Code w/Indiana Amendments
(Multi-Family Constru~on Code)
E TI :
Earl- Release Manufactured ~: (Check all that apply for the new
Y' · ~ ' _.~Y__N ~//constru~construction area)
Perm,t. Y _jG~N Trusses.
· ~ ~ · ~'/ [] CRAWLSPACE E2 POST & BEAM
Lot Split, __Y __~N Sump Pump. ~Y~__Y__N [] SLAB t ~ BASEMENT
Does
any part of the property lie within a special Flood designation area: _iY N WALKOUT:__Y_~i_N
Fo~ Si~. g]¢ Family and Two Family dwellings, ~dditions, remodels, and/or acces~o~;y stmct~$~, thi~ p¢~ l~ yard only if construction comm¢~ces
wathin 180 days of the date of issuance of the building permit, and must be cod3~t~4~'(~ff~ gf ~c/:llb~:~}!~} .~ months of the
issuance date. Class I structute permits are subject to the General Administr ativglgttl,~(~ the Stat~ of Indiana~ (See 675 IAC l~)~ding expiration
time frames for beginning and completing cons~ctibn
I, the undersigned, agree ~at a~,? c~nsU'u.c, don, recon?raction, e~at, gement, reloca~ ~: a~:e~on, ~t ~ ~,~;:0~ ~3 ~a~g~ in the use of land or
structures requested by this app[icauon will comply w~th, and conform to, all appiicabl~:lmSx~ of ~ Sta~e6£ ~a~ and tile ~Zo~ce of Cannel
Indiana - 1993" (Z-~89) and amendments, adopted under authority of LC. 36-7 et sq~ ~e~t~ ~embly o[ cbc S~a~ of tndian~ and ?~&ct~ ~eedatory
used or occupy, ed un~ a C&~LEcate o[Occup,~c?h~~ent of Community;$S?t~'~al. Indiana.
OFF[CE U~E O~LY: ************************************************
Flhng Fees: ~ __
Base Inspections: ~/'YJ~'Pc~?/ # Charged Re-
Under Slab Reviews
Cert. of Occupancy: ~/
Final P.R.LF.:· Additional Fees
Dept. of Community Services