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05120087-Application
RECORD: PROPERTY OWNER: New Structures, Additions, Remodels, Tenant finishes, & Accessory Buildings PHONE FAX ZIP FAX~ & PRO3ECT SUITE # (If Applicable) Lot # and Subdivision (If Applicable) [ONING: OR TENANT NAHE: ~)F/~ ~u' c~ ~OPE(S)OF ~ FDN ~ ~ ~E: ~ ] SP~ ~E~S): ~ER ~ ~ ~ ~ OF ( PRO~D~: <~ ~ ~ ~ ~UD[NG ~ND VALUE) ~ ~HH[~ON f B~ / ~ ~ NUHBE~; ~D/OR ~ of R~m: ~ r UR: ~ Y~ B~. C~ON ~E: ~UPANC ~ N~ ~U~ (P~ ~n~ ~ ~ ~D~ON and m~l ~c~n~m ~ ~(s) am c~m~dal) ~ ~ ~ ~ M~nlneor~ : Bldg ~, ~HOD~ ~ N~ ~ ~ ~u~ ~ A~ESSORY BU[LO[~ dl ~lch ~ D~ACHED G~GE n~ ~n~ area) ~ A~ACHED ~ ~ ~WL SPACE ~ CE~WER (N~) ~ C~L TOW~ ~-L~ ~ ~EME~ ~ D~O~ON FOOTAGE: PR- : TN . =-T~: : EaHy Release XZ} Manufactured ~"'~/]N Permit: X /~1 Tresses: _Y Lot Split: ~.~N Sump Pump: Does any par~ of the property lie within a special Flood Plumber's Zndiana State Ucense #: ~.r) Filing Fees: # Charged P.e- Base Inspections: Reviews Meter Base } Additional Fees CONMERCIN.