HomeMy WebLinkAbout04110154-Application~UZLDER of
RECORD:
OWNER:
MulU-Famil¥, & Two Family: New Structures, RddiUons, Remodels, & Accessory Structures
PHONE
FAX
STREET ADDRESS
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PHONE FAX
&PRO3ECT '~¢ ~*~'~ ~*/~' / ?~:
INFO: ~D~SS OF CONS~UCnON
ZIP
.SECT[ON
5--~'Z~ ~'~- ~ ~.~'
ESTIHATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE)
4 HOME
[] 'P~/O FAMILY
# of units:
[] MULTi-FAMILY
# of Units:
[] RESIDENTL~L (For
Additions, Remodels, Etc.)
Permit.
Lot Split:
-P F- R- _ MENT:
CD NEW STRUCTURE
{~i[L ROOM ADDT~ON(S)
E3 PORCH ADDTFJON(S)
E:J REMODEL
[] ACCESSORY BUILDING
DETACHED GARAGE
_.z~_Y N
PLUMBTNG :: - ~ -- OR:
[]
(HulU-Famil'
FO" - -- ~- N; -PE:
construction area)
WALKOUT:~Y N
tsanancc d~c, Class I str~cture permits arc anbjcct to thc General Aclmintstrativc Rnles o£ tbe Sr~ce of Indiana (See 675 1AC 12) regatcling exp~a~on
time frames for beginning and completing construction.
I, thc undersigned, agree ~ any construcnon, reconst~ucuon, enla~gemant, I~..location, or alteration o£ a structure, or any change in the u~e Of land or
st~mctores r~q~u~ested by tfus application will comply veith, and conform to, alt applicable l~ws of the State o£ Indiana, and the 'Zo '_m~_ 0rdLmmce o£ Oxmel
Indiana- 1993 (Z-289) and am~mdments, adopted under authority of I.C. 36-7 et ~eq, General Assembly o£ the State of Indiana, and all Acts amandatury
thereto. I ~urther c~ that only kitthan, bath, and floor clra~s a~e com~e~tetl to the sanitazy sewer. I further cer tlfy tlmt the commmction wLil not be
~ ,ar oec'~t?ted ~tll ~. Ge~t:e ot'O¢CUl~acy'has been Issued by the Department of Community Services. CNtmel. IndJan~
Sign~u~e oflOwn~r or Autl~zed Ageat Pnl~t D~te
· ' lng Fees:
ZNSPECT/ONS REQUZRED. ,-/ - ~ --
Base ]inspections: ~ # Charged
Reviews
Upper roofing Lower FooUng Under Slab
eter Base Final Site
Services (Date)
Cert. of Occupancy: