HomeMy WebLinkAbout05050021-ApplicationPROPERTY
OWNER:
LOCAT/ON
For Single Family, Hulti-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER'S EMRIL ADDRESS B~ST METHOD OF CONTACT: ~/~.)
& PROJECT -- --
TN Fi"~. ADDRESS OF CONSTRUCnON
SEWER UTZUTY ~,~
PROVIDER: ~ ~ PROVIDER:
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW ~
NUMBERS; TAC DAT~(S); AND/OR COUNTY WFLL AND/OR SEPTIC PERMIT ~ IIF APPLIC~):
/00
~ SINGLE FAMILY
[21 TOWN HOME
ED TWO FAMI?.Y
# of units:
[] MULTI-FAMILY
#ofUnts:~
[2] RESIDENTIAL (For
Additions, Remodels, Etc.)
- E- - -_ :-:_, : PLUMB~L~:
[] NEB/STRUCTURE __
O ROOM ADDITiON(S)
[] PORCH ADDFF~ON(S)
[] REMODEL
~ A~RY BUILDING Wh~ ~u~l~ ~ will ~ a~ll~ ~ ~e ~on:
~ D~ACHED ~GE ~ In~maUonal R~denUal ~e w/I~iana Amendmen~
A~A~ED ~GE ~ Uni~ ~um~ng ~e w/~ndia~ ~endmen~
DEMO~ON (Mul~-FamUy ~n~ ~)
~: (~eck all ~t apply for ~e new
Man~a~u~ ~n~on a~)
~N T~: Y N
~ C~W~PACE ~ ~ & B~M
~ ~EME~
W~O~: Y .~ N
~care of O~upancy ~ed) ~ 18 monr~ of the
~ I ,mcture p~ ~e subject ~o ~e ~er~ A~a~ve R~ of ~e State of InCa (See 675 ~
~e ~m~ for ~g ~d comple~ng consmc~on.
r commc~on, r~nsmcflon, ~m~ r~a~on, or ~r~don of a smcmm, or ~y ~ge m ~e u~ of ~d or
ply ~ ~d co.om m, ~ app~cable hws of ~he Store of ~ ~d ~he
~d fl~r ~s m ~r~ to ~e ~ sew~. I ~h~ c~ ~ ~e constmcOon
-&o5 _
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P.R.I.F.:
(Da~) ~ ~ by:
~lent
OFF~CE USE ONLY:
Upper Footing Lower Footing ~ U_ nder
Rough In Meter Base Final
-Additional F%