HomeMy WebLinkAbout05060041-Application ' Tow//~h~_~ Permit; 1
INS?ITU?IONAL IMI~ROYEM]~i~rT LOCATION PEILMIT ~PLICATION
~f
PROPERTY
OWNER:
]uildlng (If different
STATE
BEST HETHOD OF~NTACT:
PHONE
3q& 2..
CITY STATE
SUHE # (If Applicable)
Lot # and Subdivision (If Applicable)
FAX
-/ga- 2qzt,
¥6o$3
ZONING:
are commercial)
PROVIDER:
Applicable):
ESTJHATED
(EXCLUDING LAND VALUE)
BLDG. CONStrUCtiON TYPE:
TYPE O- ,MP : : .P_.~)~I~NFO '- - _:
[] NEW STRUCTdRE Early Release
[] ADD~r'ION Permit: __y
[]
Lot Split:
designation area: .
Manufactured
SLAB
POST&BEAM
(or POST & PIER)
(~ CRAWL SPACE
0 BASEMENT [] CELL TOWER CO-LOCATE
WALKOUT:V'~Y___N U) DEHOLtTJON
~dministrative Rule~ of the State of Indiana (See 675 IAC 12) regarding expiration time frames for
7 et s, ~ of Indiana, a~d all
Indiana.
/
Under Slab
Filing Fees:
# Charged Re-
Base Inspections: Renews
Cert. of Occupancy:
TOTAL ' Additional
Services
Feel