HomeMy WebLinkAbout05020065-ApplicationFor Single Family, Hulti-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
RECORD:
PROPERTY
OWNER:
LOCATION
& PRO3ECT
INFO:
SEWER LI~L~'I'Y
PROVIDER:
PHONE FAX
BUILDER'S ENA[L ADDRESS
NAME
STRE.~ ADDRESS
BE~T METHOD OF CONTACT:
PHONE FAX
__ 0/?-
~ ~A~ ZIP
)F CONSTRUCTION~ /
SECT[ON
(EXCLUDING LAND VALUE)
SQUARE
FOOTAGE:
PLAN COHMISSIO~
NUMBEP~; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PEP~liT #~ (IF API~CABLE):
- E F , : ,_--:':
~' SINGLE FAIVIILY
TOWN HOME
E3 TWO F^MI~¥
# of units:
I~) MULTi-FAMILY
# of Units:
E~ RESIDENT[AL (For
Additions, Remodels, Etc.)
Early Release
Permit: Y v/N
~ NEW STRUCTURE
[] ROOM ADDITION(S)
[] PORCH ADDiTION(S)
[] REMODEL
[] ACCESSORY BUILDING
[] DETACHED GARAGE
[] A'FI'ACHED GARAGE
[] DEMOLT~ON
Hanufactured
Trusses:
Sump Pump:
PLUMBING
Plumber's Indiana State
Which plumbing code~
{~Znternaflon;
{~Uniform Plumbin
(MulU-Famil~
F- NDAlI N TYPE: (Check
~/Y N / ~/construe'don area)
~ c/ L~CRAWLSPACE [] POST & BEAM
Y ~N [] SLAB [] BASEMENT
part of the property lie within a special Flood designation area: Y ~¥N W'ALKOUT: 'I~i~-
d!u,'ons, remod
I within 180 days o£ the chte o£issuance of the builaing permit ~ua must be compl~c~9~ ~iq,~]acy ~¢0) ~W~. ~mm:,ns ntonths of tac
issuance date. Class I structure permits are subject to the General Administxative Rules bf th~ ~' I~:a~ f ~ 6~P~J ~l~ing expiration
and conform to, all applica~ ~ ~f~e ~t~f ~e'~d~n~, e of Cannd
~ o£ I.C. 36-7 et seq, C'eh~r ~1
connected to the sanitary sewer. I furtli~t the construction will not be
it lndiana~
Bate
Filing Fees:
Base InspecUons: ~ # Charged Re-
Under Slab ~.~0 ' 0 O Reviews
Cert. of Occupancy:
PZ.I,F.: