HomeMy WebLinkAbout05080165-Application i~SIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Sb'uctures
BUILDER 0------'--'~ ~ , ' PHONE
RECORD:
~S C2TY STATE ZIP
BUILDER'S EMAIL ADDRESS ,t t ~ ~. b-- --- OF CONTACT:
PROVIDER: PROVIDER: ~ {P~3 ~
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMiSSION I BZA / BPW DOCY, ET
; AND/OR COUNTY WELL AND/OR SEFq'IC PERMIT #'S (IF APPLICABLE):
-.-'N · - :
~ SINGLE FAMILY
~ TOWN HOME
[] TWO FAMILY
# of units:
[] MULTi-FAMILY
# of Units:
~ RESIDENTIAL (For
Remodels, Etc,)
-- : Fl' '- 1=, :
~ NEW STRUCTURE
ROOM ADDH"ION(S)
PORCH ADDITION(S)
REMODEL
C] ACCESSORY BUILDING
[] DETACHED GARAGE
[] ATYACHED GARAGE
C] DEMOLITION
Manufactured
Y __~__N Trusses:
ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE)
~r International F
[] Code w/Indiana Amendments
(MullJ-Family Consb'uction Code)
~: (Check all that apply for the new
construction area)
[]] CRAWLSPACE []] POST & BEAM
[] SLAB
Cert. of Occupancy:
T