HomeMy WebLinkAbout05020082-ApplicationFor Single Family, Multi-Family, & Two Family: New Structures, AddiUons, Remodels, & Accessory Structures
BUZLDER of
RECORD:
PHONE
CITY
PHONE
STA'~E
BEST METHOD OF CONTACT:
PROPERTY
OWNER:
FAX
& PRO3ECT
ZNFO:
SECTION
Cos~ o,
LAND VALUE)
ZONING;
/
FOOTAGE:
NA~E OF U'i'ZUTY EXCAVATION CONTRACTOR; PLAN COHMISSION / BZA / BPW DOCKET
~ STRUCTURE
TOWN [] ROOM ADDITION(S)
C~ TWO FAMILY [] PORCH ADDITION(S)
# of units: [] REMODEL
C3 MULTI-FAMILY
# of Units: [] ACCESSORY
C~ RESIDENT[AL (For []
Additions, Remodels, Etc.) ~
PR - - ;- -T~ :
Plumber's Tndiana State I
r thenew
-- CRAW[SPACE [] POST & B
Lot Split: Sump Pufitp: [] SLAB
Does any part of the property lie within a special Flood designation area: Y WALKOUT:
idons, remodel~essory structures, this perm/t~ only if construction commences
within 180 days of the date of issuance of the building permit, and must be completed (Certificate of Occupancy issued) within 18 months of the
issuance dat~ Class I structure perm/ts are subject to the General Administra~ve Rules of the State of Indiana (See 675 IAC 12) r~g e~a~on
time frames for beginning and completing construction.
I, the undersigned, agree that any construction, veconsrtuction, eaxtargement, relocation,
structures re,q~ested by this application will comply with, and conform to, all applicable laws o[ the State of Indian~
Indiana- 1993 (Z-289) and amendments, adopted under anthority nf LC~ 36-7 et seq~ Generat Assembly of the State
thereto. I further certify that only kitchen, bath, and floor drains axe connected to the sanitary sewer. I further certify that the construction will not be
~ or occupied until a Cerr?'cate o£Occr~loanqy has been issued b~y~ the Department of Community Services, Carmel, Indian~.
5t0ea~re of Owfier ~ authorize~ ,~ent ~int
Filing Fees:
~# Charged Re-
Base Inspections:
Cert. of Occupancy:
f Communib/Services (Dale)