HomeMy WebLinkAbout05050127-ApplicationTownship
For Single Family, Hulti-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BU1rLDER Of P.ONE
RECORD: ,
PROPERTY
OWNER:
STREET ADDRESS CTTY STATE
BUILDER'S EMAIL ADDRESS BEST METHOD OF CONTACT:
NAME PHONE FAX
* 00 ,f&,?'- /777
CITY ~I*ATE ZIP
LOT # SUBDIVISION NANE SECTION ZONING:
NUNBE~; TAC DA~(S); ~D/OR PE~ ~ (IF A~H~
TOWN
GARAGE
(For ATTACHED GARAGE
~ DEMOLITION
Plumber's Indiana State License #:
Which plumbing codes will be applied to the cons~ructinn:
[~Intemational Residential Code w/Indiana Amendments
[~ Uniform Plumbing Code w/Indiana Amendments
(Multi-Family Construction Code)
P N :
FOUNDA~ON TYPE: (Check all that apply for the new
Early ~R. elease / Manufactured
Permit, y v N Trusses:
· / ~y [~ CRAWLSPACE
&
BEAN
Lot Split, .___.Y ~N Sump Pump: N r-~ c, ^
any part of the property lie within a special Flood dseignaUon area: ____Y __N , WALKOUT:. y u/N
~ and Two Family dwellings, additions, remodels, and/or accessory structures, this permit is valid only ff construction commences
lays of the date of issuance of the building permit, and must be completed (Certificate of Occupancy issued) within 18 months of the
~ance date. ~~ass~~ttucture~ermitsares~bject~~theGeneralAdmInis~rativeRnles~f~heS~ate~fIndiana(See675~AC~2)regardingex~iration
time frames for beginning and completing construction.
I, the undersigned;agree that any construction, reconstruction, enlargement, relocation, or alteration of a structure, or any change in the use of land or
structures requested b tpplicable laws of the State of Indiana, and the "Zoning Ordinance of Carmd
Indiana - 1993" (Z-289) and amendmenu ! I.C. 36-7 et seq, General Assembly of the State of Indiana, and MI Acts amendatory
thereto. I further certify that only kitchen, bath, and ~ sewer. I further certify that the construction will not be
Signature of Owner or Authorized Agent Date
OFF%CE USE ONLY: ************:
# Charged Re-