HomeMy WebLinkAbout05040187-Applicatione
RECORD:
PROPERTY
OWNER.
For Single Family, Hulti-Family, & Two Family: New Structures, Additions, Remodels, & Acc~_ssory Structures
FAX
LOCATJ[ON
& PROJECT
ZNFO:
PROVIDER: ROV~DER:
CONTRACTOR; PLAN COMMISSION / BZA / BPW ~
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE):
SQUAR~
ES'~MATED COST OF CONSTRUCTION: ~
(EXCLUDING LAND VALUE) ~-~
[] NEVV STRUCTURE
HOME [] ROOM ADDITION(S) Plumber's Indiana
[] TWO FAMILY
~ PORCH ADDITION(S)
# of units:__
[] MULTI-FAMILY [] REMODEL
# of Units: [] ACCESSORY BUILDING Which plumbing c~es will ~e appli~l t~ the
[] RESIDENTIAL (For [] DETACHED GARAGE []] IntemaU~nal Residential Cede w/Zndiana Amendments
Additions, RemOdels, Etc.) [] ATTACHED GARAGE [] Unifenn Plumbing Cede w/[ndlana Amendments
[] DEMOLITION
(Multi-Family Construddom Code)
/ ~[~1~L~]~: (Check all that apply fer the new
Pel~nit: __y~ censtrucfien area)
Lot Split: Sump Pump: _y ~ I~PACE [] POST & BEAM
~ ~ny Pa~: of the Prel~r~ lie within a ~:t~l Flood d~ignation ~re=: y w.~J-~0u'r:Y
For Single ~amil7 and Two Family dwellings, additions, remodels, and/or accessory strucrure~ this ~¢rmit ~ w~.~ ~ ~'
lS0~aYs°fthedat:e°fz~aa~ceofthcbuildmgl:~errmr~andmustbecom leted C
p ( ertfficate of Occupancy issued) wlrt~ 18 moiatl~ of the
£ssuance date, Oars I *m.~cture pernfits are ~b]ect to the General Administrative Rule~ of the Stare of Indiana (See 675 IAC 12) rega~in§ expiration
lime frames for begfnnin§ and compler~g construction.
~.~ ~_~ ~r~.u.~'-m ~ r-ms~ app.ucauon wm comply w~m, a~ comorm m, all applicable hws of ~¢ Smta of Indiana, mad thc .Zo~ ordinance of Carmd
malam - ~ [~t289/en~ amendments adopted un¢~mlm~ty of I C 36~7 el: seq General Assembly of the State of Indiana and ~ A,-,~
~th~o- }?_.._r~_.~er~c~ th~at o .riley kil:ch~en2 bath, a~, oo~r dra~, s ~re colllaectcd to the samra~ sewer. I further cer~ that the constrllction will not be
r u,zcup~xa lmm a t~ ~,'r~cat:e o~ ~ccnlm~¢y'na~ t~en ms,ed By the Department of Community Services C. arm,-1 l.,h.~
~ .. ~*~ ~ ~ *~*~*~
IF CAF{ ~EE'I}"~¢Y TOWNSHL__
~e:V~~ iNDIANA 61 TOTAL~L/~ .~
Fee Received bY: .~ ~ - --