HomeMy WebLinkAbout05020141-ApplicationPROPERTY
OWNER:
PHONE
STA~
OF CONTACT:
LOCATION
of Shell Building (If different than Address ofl
SUITE #
ZONING:
~, CD ELEC CD SPKLR OTRER(S):
ES~HATED COST (
Early Release
INSTITLq~ONAL
Municipal/Public mldg
SLA~
POST & BEAM
LotSplit: y_
FINISH
[] ACCESSORY BUILDING :
[] DETACHED GARAGE r~ ....... ~ ~. ~ ~ ~ '
~ ATFACHED GARAGE
[~) CRAWL SPACE E3 CELL TOWER
C~ BASEHENT C] CELL TOWEl k:ense #: ~.~.J
WALKOUT: y N C~l DEMOLTI'~ON
State of Indiana (S~e 675 lAC 12) regarding expiration time frames for
e in the use of land or structures
of Cannel Indiana - 1993"
and all Acts amendarory thereto, I further certify that on y
a Cerg~ca~ at'
Print
INSPECTIONS REQUIRED:
Base Inspections:
Ce~. of Occupancy: