HomeMy WebLinkAbout05040166-ApplicationBUZLDE~ of
RECORD:
New structures, Additions, Remodels, Tenant Finishes, & Accessory Buildings
~P~ONE FAX
PROPERTY
OWNER:
%NFO:
· ADDRESS
Address of Shell Building (If different than Address of Construction)
Lot # am Applicable)
STATE COMMERCIAL SCOPE(S) OF
FOOTAGE:
SEWER UT[L[TY
PROVIDER: / PROVZDER:
PLAN COMM[SSION/ BZA ! BPW DOOCET NUMBERS; AND/OR
COUNTY WELL AND/OR SEFI~C PERMIT #'S (If Applicable):
EST[MATED COST OF CONSTRUCTiONal ~.~
(Privately owned hospitals
and medical offices/centers
am commercial)
which
CRAWL SPACE
POST & PIER) WALKOUT:YN
Lot SPlit: Y Sump Pump:
Does any part of the properly lie within a special flood
designaUon area:
Plumber's Indiana State License #:
been issued b
Under Slab
Site
Pdnt
. (See 6751AC 12) regarding expiration time frame
x the use of land or structures
~armel Indiana - 1993' (Z-
all Acta amendatory thereto. I further certify that only
~e used or occupied un~l a Cert.'cate o£