HomeMy WebLinkAbout05100022-Application Permit #:~
IMPROVEMENT LOCATION PERMTr APPLICATION
New Structures, Additions, Remodels, Tenant Finishes, & Accessory Buildings
BUILDER of
RECORD:
OWNER:
STREEt ADDRESS
CITY STATE ZIP
BUILDER'S EMAIL ADDRESS BEST METHOD OF CONTACT: 7/~'
PHONE FAX
LOCATION
& PRO3ECT
INFO:
~r)DRESS OF CONSI~U CT]ION
suTrE #
, PRO3ECT, OR TENANT NAME:
STATE COMMERC3AL
DESIGN RELEASE #:
wATER UnLrr~/, SEWER unLr.
PROVIDER: ~1~m ~ PROVIDER:
PLAN COHblIS$ION [ BZA / BPW DOCKET NUMBERS; AND/OR
COUNTY WELL AND/OR SEF12C PERHIT #S (If Applicable):
or L~: ~]
~C~ COMMERCIAL
[] INSTTPJT[ONAL
[] Munidpal/Public Blog
[] Church
Y:g[[~[~_T[~L~; (Chec~ all which
apply for the new construction area)
/~ SLAB [] CRAWL SPACE
POST & BEAM C~ BASEMENT
(or POST & PIER) WALKOUT: Y N
requested by ~ application will comply with. and confutm to,
TYPEOF_- - V=- -N :
[] NEW STRUCTURE
C3 ADDITION
Room(s)
Porch
[] Me~anine or Deck
[] REMODEL
~ NEW TENANT FINISH
[] ACCESSORY BUILDING
[] DETACHED GARAGE
[] ATTACHED GARAGE
[] CELL
[]
[] DEH
: -: - ON:
Early Release Manufactured
Permit: Y _z~__N Trusses: Y XN
LotSplit: ~ X'N SumpPump: Y_~N
Does any pert: of the property lie within a special Flood
designation area: YX' N
U, - G --- OR:
'--'-' ' ' -- - .~--:]' -' _~-~..,,~z.- 47.0,
) regarding expiration time frames for
change in the use of land or structures
Ordhumce of Carracl Indiana- 1993' (Z-
thereto. I further certify that only
OFF~CE USE ONLY: ************************************************************************
tNSPECT~ONS REQUZRED." ~)~--~ FJlinn Fees: /'~ q 7~' (~
,¢~ I/J_~ = ' ' - --
Upper Footing Lower FooUng Under Slab I D J Ir_ . , / ~ ~7 ~'~/~ # Charged Re-
; base ~nspec~lorts: - _. _- ~ ~-~ C~' _ Reviews
f TOTAL 2 t Additional Fee--'-~
Reviewed/*p~o~ed '~~