HomeMy WebLinkAbout05050078-Application City of Cartnel /Clay Township permit
REsiDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Hulti-Family, & Two Family: New Stru~cures, Additions, Remodels, & Accessory S~ructures
PHONE FAX
PROPERTY
OWNER:
BEST METHOD OF CONTACT:
LOCATZON
& PRO3ECT
ZONING:
[] SINGLE FAMILY
[] TOWN HOME
[] TWO FAMILY
# of units:__
[] MULTI-FAMILY
,._~ # of Units:. __
~ RESIDEN'I-~L (For
~ Additions, Remodels, Etc.)
[] NEW STRUCTURE
[] ROOM ADDITION(S)
C] PORCH ADDiTION(S)
[] REMODEL
[] ACCESSORY BUILDING
[] DETACHED GARAGE
~DE~)CHED GARAGE
Lt-I~Ol~
Plumber's
Which plumbing codes will be;
[] Zntemaflona
[] Uniform Plumblm
(Muiti-Family
~PE: (Check all that apply for the new
Early Release Manufactured ~ construction areal
Permit: _Y_.~N ~LS~pp:ump '~"~ (~/~CRAWLS;,~E [] POST &BEAM
Lot Split: Y 7~.N :
Does any part of the proper'o/lie within a special Flood designation area: Y N WALKOUT: Y N
For S~gic ~F~t~¥ a~d Two I=4¥ dwciU~gs, ad~rJons, rcmodc!s, a=~/or ~cccssoz~ sc~uc~u~s, c]~ ~mic is valid o~ty E cons~z~cdo~ commcaccs
w~ch~ 180 d~¥s o£ r~c dace o£
issu~acc ct~r~ Chess ! sr~uccu~c perm~r~
cimc ~amcs £or I~l~d~g a~d comp~cCiag co~s~-ac~on.
L c~c u~dc~s~g~cd, a~cc d~c ~ co~s~uc~o~, rcco~s~cdo~, c~a~cmc~c, ~J. ec~do~, or a~cc~do~ o[ a s~uccu~¢, o~ ~¥ _c~a_~c ~ r~c usc o~ la~d o~
L~d~ - laP3~ (Z~289) ~d
r~c~cm. ! [u~r~
usc~ or ~cap~cd
Signature~of Ov~li~r Authorized Agent Print Date
OFFZCE USE ONLY: ************************************************************************
Rling Fees:
Base inspections:
Cert. of Occupancy:
P.R.I.F.:
# Charged Re.,
Reviews
Additional Fees
TOTAL: