HomeMy WebLinkAbout06010001-ApplicationCity of Cartnel/ Clay Township
Permit
BUILDER of
RECORD:
PROPERTY
OWNER:
LOCATION
&PRO,
PHONE FAX
STREET ADDRESS CITY STATE ZIP
EMAIL ADDRESS BEST METHOD OF CONTACT:
STREET ADDRESS
FAX
PHONE
CiTY STATE
SECTION
ziP
r ~ SUBDIVISION NAME
INFO; ADDRESS OF CONSTRUCFION SQUARE
FOOTAGE:
~_ (EXCLUDING LAND VALUE)
-P - F -N R_ - N: [~ ~P OF IMPROVEMENT: PLUM
~SINGLE FAMILY ~' ~ ~ NEW ~RU~URE
~ TOWN HOME ~ l
~ ~O FAMILY
~ of uni~:
~ MUL~-FAHILY ~ REMODEL
~ ~ of UnJ~
RESIDEN~ [For
Additions, Remodels, Etc.) ~ DEMOLITION
~ IN- OR~A~ON: ~)~l~'v ConstructJon
Early ReJ~se Manufa~u~d FOUNDA~O~PE: (Check all that apply ~r the new
Per'it: Y ~N Trusts: Y ~N constru~ion area)
~ C~W~PACE ~O~ & B~N
Lot Split: Y ~N Sump Pump: Y XN g S~B ~ BASEMENT
Does amy pa~ of the prope~ lie within a special Flood designation area: Y ~N WALKO~:Y
~&~a - 1993" (Z-289) ~d ~cDdmc~s adoptc~ ~cJct ~uthod[y o~ I.C, 36-7 c~ scq, G~c~ Assembly o[ ~hc St'=tc of In~a~a. ~nd ~ Ac~s ~mcnda~o~
OFFICE USE ONLY ***********************************************--*******************
Ce~, of Occupancy:
P.R.I.F,: Addi~ona Fees