HomeMy WebLinkAbout05030139-Application Township Permit #:__
INSTITUTIONAL IM:PRO~ LOCATION PERMIT APPLICATION
For Commercialor InstituUonah New ~ructures, Additions, Remodels, Tenant Finishe~, &Accessory Buildinga
PHONE FAX
PROPERTY
OWNER:
& PRO.1ECT
INFO:
Address of C
SUITE ~ (If Applicable)
SCOPE(S) OF o FDN
~ ELEC
PROVIDER: PROVIDER:
/ BZA / BPW DOCKET NUMBERS; AND/OR
COUNTY WELL AND/OR SEPTIC PERMIT #'S (If Applicaffe):
~' ARCH ~MECH ~ PLUM
SQUAR~
FOOTAGE:
[] IN
Church
which
[] CRAWL SPACE
(~} POST & BEAM C3 BASEMENT
(or POST & PIER) WALKOUT,V' y N
NEW STRUCTURE
Early
Permit: ~Y_~N Trusses: Y ~ N
Lot Split: _Y J~._N Sump Pump: Y ~-_N
Does any part of the property lie within a special Flood
designaUon area: Y~CN
ATt'ACHED GARAGE
CELL TOWER(New)
CELL TOWER CO-LOCATE
[] DEMOLITION
Sta~e of Indiana (See 675 IAC 12) regarding ex:pit at/on time ~ram~ for
· or any change in the usc of land or structures
with, and conform to, all applicable laws of the State o[ IndJ~llaI ~ th/: "Zoning Ordinance of Carmd Indiana - 1993" (Z-
of I.C. 36-7 et ~q, General Assembly o£ the State of Indiana. and all Acts amendatory thereto. I further certify that only
. sewer. I/xtrther cert~ that the construction will not be used or occupied until a Cett:~Zat¢ o[
been i~ued by the l~partment of Community Services, Cannel, Indiana.
INSPECTIONS REQUIRED:
Filing Fees:
Slab Base Inspections:
Site Cert. of Occupancy:
TOTAL:
# Charged Re-
(Date)