HomeMy WebLinkAbout05120113-ApplicationPROPERTY
OWNER:
Permi '
APPLICATION
For Single Family, Multi-Famil~&~w~vo ffm~ily~ New Structures, Additions, Remodels, & Accessory Structures
ShannOn HlnshOtU Ho E.
SrRE~ADDRESS - SOIl 011 ~ . sr^*~ z~P
NAME PHONE FAX
STREET ADDRESS CITY
LOCATION
& PRO3ECT
INFO:
SQUARE
=AMILY
TOWN HOME
! ~OFAMILY
# of units:
MULTI-FAMILY
Units:
;IDENTIAL (For
PROVIDER: ~.~.m~ TbU~ PROV!DER:
TYPE OF IMPROVEMENT:
E] NEW STRUCTURE
CZ] ROOM ADDITION(S)
E] PORCH ADDITiON(S)
REMODEL
E] ACCESSORY BUILDING
CJI DETACHED GARAGE
LAND VALUE
State License #:
Which plumbing codes will be applied to the construction:
[~L4[nternational Residential Code w/Tndiana
[]]] Uniform Plumbing Code w/Tndiana Amendments
CZ] ATFACHED GARAGE
Remodels, Etc.) []] DEMOLITION
.~ (Multi-FamilyConstruction Code)
i - ~, ~r~%~C!~, gU~a~.j,I' ~]~]~ ~ ~P~UNOAT[ON TYPE (Check a that aPp V for the new
Ear!y Rel~: .~ ~t.~a~ur~ L~ ~th ~~ ~.~..~; .....
Lot SP!,t: ~y~N $~p~~ ,,. ~ ~ ~B ~ BASEMENT
dmc E~mcs t~ 6eDnning ~nd com~cdz~g consu'ucdon.
OFFICE USE **************************************************
Reviewed/Approved: Dept, of Community Services (Date)
Filing Fees:
Base Inspections: ~/0 # Char'ged Re-
/.~ Reviews
Cert. of Occupancy:
P.R;I.F,: 0 ~) Additional Fees
TOTAL:
Fee