HomeMy WebLinkAbout05060053-Application Permit #:__
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUZLDER of J~HeNE ~ F~X
RECORD:
~ROPERT~ ~ ~o~
& PRO3ECT
]'NFO:
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE):
ESTIHATED COST OF CONSTRUCTION:
EXaUDm DVALUE
SINGLE FAMILY
[] TVVO FAMILY
# of units:__ []
[] MULTI-FAMILY []
# of Units: []
[] RESIDENTIAL (For [] AqTACHED GARAGE
Additions, Remodels, Etc.) [] DEMOLITION
: i -N - - _ , -~.:
Early .Release
[] Uniform Plumbln!
(Multi-Family Construddon Code)
Manufactured
Trusses: Ky __N
Sump Pump: )~ Y N
lie within a special Flood designation area: Y __N
F- DAT~ON -P : (Checkall
construction area)
A CRAWLSPACE [] POST & BEAM
SLAB ~ BASEMENT
WALKOUT: Y
N
For. S/~. gle Family and Two F _a?ily dwellings, additions, remodels, and/or accessory structures, this permit is valid only ff construct/on commences
· within 180 d~ys of the date of issuance of the building permit, and faust be completed (Certificate of Occup~cy ~u~) ~ 18 mont~ of the
msuanee date. CLass I structure permits are subject to the General Administrative Rules of the State of Indiana (See 675 IAC 12) reg~g ~on
time frames for beginning and completing construction.
I, thc undersigned, a~ee .fl~ a~..y c~nstru.c, tion, recon~tract~on, enlargement, relocation, or alteration of a structttre, or any change ~n the use of land or
st~.,ctores ~...q~. e~ted by this applicataon will comply wath, and conJorm to, all applicable laws of the State of Indiana, and the "Zoning Ordinance of Ca.tmel
Indiana - 1793 (Z-289) and amendments, adopted under authority of LC. 36-7 et seq, General Assembly of the State of Indiena, end all Ac~ amendatory
thereto. I furry, er ce~., that only kitchen, bath, and floor drams a~e connected to the ~anitary sewer. 1 further certify that the constructinn will not be
used{ar occupied until a Cei~eate o£Occupm';cyhas been issued by the Department of Community S~ O~l~l{t~la~{ ~ ~ @
OFF~CE USE ONLY: *************************--*********************************
Flhng" Fees.' ~" ~'~C
Base Inspections: ~ # Charged
Cert. of Occupancy: __~ Reviews
P.R.I.F.: ~- Additional Fees
TOTAL:
S:PermltrdR~l~.P RE~DENTI~
Services (Date)
FeeR