HomeMy WebLinkAbout05020121-Application Perm t #.
LOCATION
For Single Family, Multi-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
~. pHONE FAX
J BUILDER'S ENA[L ADDRESS .,. ~
PHONE
SUBD~SJON ~E
LOCATION
& PRO3ECT
INFO:
{EXCLUDING LAND VALUE)
[2~ SINGLE FAMILY
[] TOWN HOME
TWO FAMI,.LY
# of units:__
~ MULTI-FAMILY
# of Units:
C] RESIDENTLa'L (For
Additions, Remodels, Etc.)
- PE :_ -- _ ~
~EW STRUCTURE
[] ROOM ADDiTiON(S)
[] PORCH ADD1-HON(S)
[] REMODEL
ACCESSORY BUILDING
DETACHED GARAGE
[] ATTACHED GARAGE
[] DEMOLITION
PLUMBTNG
Manufactured
Y_~/N Trusses:~,/___
Y f _N Sump Pump: _~N
Does any part of the prupe~.~y lie within a special Flood designation area:
For Single Family and Two Family dwe~gs, eddiaons, remodels, and/or accesso.ry~%~ _r~fis~ea=nlrx~s ~gsl.~.'.~ .~ eommencez
~t~ m0 a~y~ of t~e &re of~anc~ or~ ~a~g~, ~a mu~be co~p~tax~c~t~o~
issuance date, Class 1 stmcnuce permits are subject to the General Administrarive Rtit~sio£zbe Statezof ~i~lana k~e~5753tAt;~t2~g expiranon
time frames for beginning and completing const~q~.'~O
I the undersigned ~;ree that any construction, reconstruction, enlargement relocation c~alt~atiqn,qf ae~t~ ,qt~ p~7~y~a~s~13~ ~f~4and or
st:mctures :equested by this application ~ comply wtr~ and co~orm tO, alt applicable 1,4WS~Of .~the s~t e~:v~ Carm
Indiana3Jg~' (Z-289~ and amendments, adopted under authority of t.C. 36-7 et seq, G~bId~i~g:~e~ ~£~[~.~ tory
there.~o51 fur~er certify tl3ae~y kitrthen, bath, and floor drains are connected to the sanitary sewer. I furtbeF ~E ~ the constractton willnot be
use~ or occg~ied until ~.~'.a~ff~icat~ofOccupancyhas been issued by the Department of Community Ser~i~:~,~ai~21~l; Indianm
OFFICE USE ONLY: ************************************************************************
Filing Fees:
~ /~'/,D t~/~ #ChargedRe
Inspections:
Reviews
Cerl:. of Occupancy:
P.R.I.F.: ~ ~ Additional Fees
/.. ~,~OTAL:~ ~ 0, A~dm~n
Date) L__. /" ,/,., :'/ ::
C
(MuttbFamily Construction (
;UNDATZON TYP_: (Check all that apply for the new
construction area)
[] CRAWLSPACE [] POST & BEAM /~.z~ ~
[] SLAB ~2 BASEMEN?. /
WALKOUT: ~YN