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HomeMy WebLinkAbout05050101-Application ///~ Permit RESIDENI .IMPROVE NT LOCATION PERMIT APPLICATION For Single Family, Hulti Family, & Two Family: New Structures, Additions, Remodels, & Accessory Structures BUZLDER of ~.~ ~ 'l, t~%__~.~ ~ ' PHONE * FAX ] RECORD: _ ] PROPERTY OWNER: LOCAl'/ON & RO=EC'r ZNFO: BUILDER'S ;MAIL ADDRESS 3F CONTACT: SEWER UTILITY WATER UTILITY PROVIDER: PROVIDER: PLAN COHHISSION NUMBERS; TAC DATE(S); AND/OR COUNTY WELL RND/OR SEPTIC PERM,' #~J (IF APPLICABLE): SECHON ~ SQUARE ESTIMATED COST OF CONSTRUCTION: #( DEMOI.~ON Plumber's Indiana State Licens~ #: .~ich plumbing codes will be applied to Ute coesta'uction: \~ Intemational Residential Code w/~ndiana Amendments ~U~-~ Uniform Plumbing Code w/Indiana Amendments (Multi-Family Constru~on Code) INSPECTIONS REQUIRED: Under Slab Manufactured . / ~,~L~: (Check all that apply for the new ~ Y N construction ama) ~ -- ~ CRAWLSPACE C~ POST & BEAM Lot Split: Sump Pump: Y N ~ .... ;~z' =^C=HENT D°es any e within a special Flood designation .arl~,,. ~o~I©NY ~ N cuar, a - 1993 (Z-289) and am~dmcnts, adopted trader authority of LC. 36.7 et secl, General Ass~bl¥ of ~c State of M~, ~d ~ Acts ~&to~ thereto. ~I further cert~ that onlr kitchen bath a~d floor drains are cormectcd m the aanita~7 sewer, I fu ~o~u-actt~n will not bc used or ~cupicd unt/l n Cerc~c~Ce o£Occul~ancybas been Lssued by the Department of Community Date Filing Fees: Base Inspections: # Charged Re- Reviews Cert, of Occupancy: ~/ ,~ J P.R.LF.: ~ ~'~& (~0 Additional'-'~ Site Services