HomeMy WebLinkAbout05040049-ApplicationFor Single Family,
BUZLDE~ of
RECORD:
PROPERTY
OWNER:
STREET ADDRESS
PERMIT APPLICATION
Family: New Structures, Additions, Remodels, & Accessory Structures
BEST METHOD OF CONTACT:
IFO:
PROVZDER: ~'~- ~ PROVIDER: ~C~[ ¥'v~_ (EXCLUDING LAND VALUE)
NUMBERS; TAC DA~(S); AND/OR COUhTY WELL AND/OR SEPTIC ~T ~'S (IF APP~CABLE): ~-[
TYPE OF I~MPROV--M -'- :
FAMILY ,~ NEW STRUCTURE
TWO FAMILY
# of units:
MULTi-FAMILY
# of Units:
RESIDENT[AL (For
Early ~R, elease Hanufactured
Permit: Y ___~N Trusses:
(MulU-Famiiy Construction Code)
FOUNDATION TYPE: (Check all
constru~
~, for the new
)FFZCE USE ONLY: **********************
Site
(Date)
InspecUons:
Cert. of Occupancy:
P.R.I.F.:
# Charged Re-
Reviews
,, O0
Additional Fees
[] CRAWLSPACE 0
Y _~_N Sump Pump: Y _~_N ~SLAB [] '
property lie within a special Flood designation are~: Y
For Single Family and Two Family dwellings, additions, remodds, and/or accessory structures, this permit is vahd only ff construction commences
within 180 days of thc date of issuance of the building permit, and must be completed (Certiflcate of Occupancy issued) within 18 months of the
issuance date Class I structure permits arc subject to thc General Administrative Rnl~s of thc State of Indiana (Sec 675 IAC 12) regarding expiration
rime frames for beginning and completing construction.
I, thc undersigned, agree that any construction, rcconstxucdon, cnlargcmcat, ~elcca~ion, or alteration of a structure, or any change in the us~ of land or
smicvares r,c.q.u, cstcd by this application will comply wit. h, and conlorm to, all applicable laws of the State o£ indiana, and thc 'Zoning Ordinance of Cannel
Indiana - 1993 (Z-289) and amendments, adopted under authority of I.C. 36-7 ct $cq, General Assembly o£ thc State of indiana, and all Acts amcndatory
the. rcm. I further cerdf7 that only kitcben, beth, and floor drains are connected ro the sanitary sewer. 1 hirrber cer~y that thc consrrncrion will not be
ttscd oltoccupied.tmrA1 a Cotrd~catc o£Occu, panc. vhas been issued by rile Dcparrrncnc of Community Services. Cannel. Indiana.
Signature of Owtner or Authorized ~gent Print ~5 Date