HomeMy WebLinkAbout05070184-ApplicationT~hip ~ ~ermit #
'PERMIT APPLICATION
For Single Family, Multi-Family, & Two Family: New Structures, Additions, Remodels, & Acce-%~ory Structures
BUZLDER of
RECORD:
PROPERTY
OWNER:
LOC. AT[ON
& PRO3ECT
INFO:
PHONE
zip
PLAN ~OMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE):
Fl; '- -
SINGLE F^MILY [] NEW STRUCTURE
[] TOWN HOMF [] ROOM ADDITION(S)
E3 TWO FAMILY ~'%1~ (~ PORCH ^DDITION~)
# of unitS:,v_~,,j..\' [] REMODEL
[2] MULTI-FAMILY ~) [] ACCESSORY BUILDING
# of Units: [] DETACHED GARAGE
[] RESIDENTIAL (For [] AlrACHED GARAGE
Additions, I Etc.) [] DEMOLITION
Which
[] lntemaflonal
Code w/Indiana Amendments
Early Release (Check all that apply for the new
Permit: Trusses: .Y v/N j ~
'um- Pum-: Y ~ O ~D FO~C~'~,!~f~
Lot Split: :~ P P -- 0 ~ect to c~arnplia~r~ce ~.gufatign~ .
Does any part of the property lie within a special Flood designation area: _L_¥~and Lo~K~___Y ~ ~ .
~;mce d~t¢. Chr~ I smlctu~ pm~its ~re subject ~o thc G~neral Admb~m~m.vc RulWoi ~I~c S~tc ~~?y ~ ~.z) rcg;~-oang cxpu~uon
ti~¢ ~'a]llcs :[or }~gJ~xTablg ;J]c~ comDlcl~/~g cok~struction.
~ - 1993' (Z-289) ~d ~, a~ptcd und~ au~ofi~ of LC. 36~7 et ~q G~bl~ ~~~ ~to~
· ~to. I ~J ~ ~t oMy ~t~, ba~, ~d fl~r &~ ~e co~t~ m ~e s~ not ~
u~d or ~pied un~ a C~re o[~cup~cy~ ~n ~u~ by ~e D~m~t of CommuM~ ~, ~el, In~, ~
~ Da~
OF~CE USE ONLY: ************* ~********* **************
XNSPE~ONS I ~. f ~ ~ aama~