HomeMy WebLinkAbout05090111-ApplicationPROPERTY
OWNER:
LOCATION
& PRO3ECT
ZNFO:
PROVIDER:
Multi-Family, &Two Family: New Structures, AddiUons, Remodels, & Acsessory Structures
PHONE
ElVJAIL ADDRESS
SUBD]VLSION NA~E
ADDRESS OF CONSTRuCIION
WATER I/rllJl'Y
PROVIDER:
NAME OF UT~Lrl¥ EXCAVATLON CONTRACTOR; PLAN COMMISSION / BZA / BPW DOOCET
NUMBERS; TAC DATL~S); AND/OR COUNTY WELL AND/OR SEPTJC PERMrF #'S (IF APPUCABLE):
[] SINGLE FAMILY
[] TOWN HOME
C~ TWO FAMILY
# of units:
[] MULTI-FAMILY
# of Units:~.
C~ RESIDENTI ,~ ~
Additions, Rem*c~%~E~.)~: ~
[] NEW STRUCTURE
[] ROOM ADDITION(S)
C3 PORCH ADDITION(S)
[] REMODEL
[] ACCESSORY BUILDING
~ DETACHED GARAGE
GARAGE
Lot Split: _Y N
Does any part of the property lie
SQUARE
FOOTAGE:
ESTIMATED COST OF CONSTRUCT]ON:
(EXCLUDING LAND VALUE)
':-:M-lNG O ' -. R: t, '
Plumber's I~cense #: -~-~'~
Which plumbing cod~s will be applied to the consb-ucUon:
[] ZntemaUonal Residential Code w/Tndiana Amendments
[] Uniform Plumbing Code w/~rndlana Amendments
(Multi-Family Construction Code)
~: (Check all that apply for the new
construction area)
C~ CRAWLSPACE [] POST 8~ BEAM
[] SLAB [] BASEMENT
~~ 1 ) rcg2 aixtm' g c:~p~atJon I
I, thc undersigned, ag~cc that: any construction, reconstruction, enlargement, ~locat~on, or ak~at~on oi a s
indial~_199~./.~.~o~__arr ~ . ~.-I ..;--,,~.ucumonn£o, auappucamelawsoi:theSr, ateoflndiana,~d~e.Zo~O~i~neenFc~.l
~e~to. IIll,t~erce~ifythat o~vkitdaen, h~th andn~-a ..... ' '. ? .......... ,y ~.~,e amteo[mcum~a a:naauActsamcudato~
k. ;.// 1:
$1gnath~ of ~r or ~ ~nt ~
OF~CE USE ONLY: ************~
~NSPE~ONS REQUZRED: Filing ~s:
Upper Footing Lower FooUng Under
Rough In Meter Base Final
~se II~spections: . ~
P.R.LF.:
# Charged Re-
Reviews
AddiUonal Fees