HomeMy WebLinkAbout05120085-ApplicationRECORD:
Permit #:~Y
[' APPLICATION
For Single Family, Multi-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Struct.res
'-'---"-'-"~o.~ ~ .~PHONE
PROPERTY NAME
OWNER:
LOCATION
& PRO3ECT
INFO: ~om~ss OF CONSll~UCTION q
SEWER unLrrr f~ t ,~-r~,~/'h
PROVIDER: [.~/V J ~
SE,CT M~OD OF CONTACT: ~.~,~
SECTION
NAME OF UTILITY EXCAVATION CONTRACTOR
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPT]C
SINGLE FAMILY
C] MULTI-FA~.ILY
# of Units:
[] RESIDENTI/~L (For
Additions, Remodels, Etc.)
qBN STRUCTURE
ROOM ADDTE[ON(S)
O PORCH ADDTF[ON(S)
O REMODEL
[] ACC~RY BU[~[NG
D~ACHED GAUGE
A~ACHED GAUGE
DEMO~ON
Manufactured
Truss~J: Y .~N
Y.~LN Sump Pump: _
property lie within a s
Wh~ plumbing
C~ International Residential Code w/~ndiana Amendments
/~ Uniform Plumbing Code w/Indiana Amendments
(Multi-Family Construction Code)
F~: (Check all that apply for the new
construction ama)
[] []] ~ BEAM
use of land or
sewer. I Drther certify that thc conmamction will not be
OFFXCE USE ONLY: ****:
Date
*********__***************
Base Inspections: # Charged Re-
Reviews
Cert. of Occupancy:
P.R.I.F.: ~ Additional ~