HomeMy WebLinkAbout05030130-ApplicationBUILDER:
OWNER:
Permit Application
Permit No.:~
,me
Street Address
Name Fax
P.O. Box / Address City State Zip
?~one ~a×
State Zip
Lot No. ~:,>:> Section Zoning
Construcuon Kt
Location: Address of Construction ~ State Zip
Estimated Cost of Construction:
(Pool and Deck) , ~l -~-
TOTAL SQ. FOOTAGE: RETYPE:
Pool Heated: Y/N
lood Zone: Y/N
,ute Filter: Y/N
Pool Cover: Y/N ~
Septic System:Y/N
Smnp Pump; Y/N ~
(il' ye~, indicate drainage on
For Commercial Pools, state
Class o£ poot__being built:
: __
Commercial Pools - provide
Sta~elease No.:
ACB of 1979, Public Law 178, Sec. 1, et. Seq., General Assembly of the State of Indiana, and all Acts amendatory thereto.
Safetyfeat~res(m¢tudmgpoolcovers)shallcomplyw~thIndlanaSw:mrmngPoolCedes675 1AC 10-4-27 Safety e tares ,
I hereby cexti~, that the improve*merit / swimm, h~g pool will not be used or occupied until a Certificate of Occupancy has been issued by
the Department of Community Services, Cannel, Indiana.