HomeMy WebLinkAbout05040041-ApplicationF~XP~D~TO RS
Permit#:
PERMIT APPLICATION
Multi-Family, & Two Family: New Structures, AddiUons, Remodels, & Accessow Structures
FAX
ST^TE
OWNER:
STREL~T ADDRESS
LOCAT/ON
& PROJECT
INFO:
~TAGE:
PROVIDER:
(EXCLUDING
PLAN COMMISSION ~
DATE(S); AND/OR COUNTY WELL AND/OR
SINGLE FAMILY
E
C] TWO FAMI,.LY
# of units:
ED MULTi-FAMILY
# of Units:
[] RESIDENT~L (For
Additions, Remodels, Etc.)
P :E I! - _' '-1
Early Release
Permit:
Lot Split: Y
Does any part of the property lie within a special Flood designation area: Y ~'"' N
- F .' - _ M NT:
S RUCTURE
[] ROOM ADD~HON(S)
CD PORCH ADD]T~ON(S)
[] ~MODEL
~ ACCESSORY BUI~ING Wh~ plumbJ~ ~es ~ll J appli~ ~ ~e ~n~on:
~ D~ACHED GAUGE ~maflonal R~denfial C~e wllndlana Amendmen~
~ A~ACHED ~GE ~ Uni~ ~umbing C~e w/[~iana ~endmen~
~ DEMO~ON (MulU-Family ~n~on ~de)
~: (Ch~ all ~atappW~r~e ~w
Y ~ ~W~PACE ~ PO~ &
~N ~ S~B ~ B~EMENT
W~O~: Y __N
nonths of the
the State of lncliana (
time frames for beginning and completing construction, .
I, the tmdersigned agree that any construction, reconstruction, enlargement, rdocation, or alteration of a structure, or any change m the use
structures requested by this applicatmn will comply with and cozfform to, all applicable laws o£ the State of Indiana, and the Zoning Ordins Cazm
Indiana-~993~289)andamendtae~ats~ad~Ptedu~derauth~rity~f~36~7e~se~q~Ge~era~Assemb~y~f~eSmte~£Indiana`andal~Act~sa . ato:~.
thereto, t further certify that only kitchen, bath, mci floor drains are con. neeted to the samtary sewer, I. further, eert~_y that the ~onstrueuon will not ue
~ or nseupied unO--Occupancy'has been issued by the Departmant of Commumty Serwees, Carmel Indiana.
OFFICE USE ONLY: ~ ************************************
~ Charged Re-
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