HomeMy WebLinkAbout05100145-ApplicationPermit #:
APPLICATION
For Single Family, Multi-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
~5-1' METHOD OF CONTACT:
PROPERTY
OWNER:
$'I~/~ET ADDRESS
& PRO3ECT
INFO:
PROVIDER: ~ PROVIDER:
NAME OF b'~L/'rY EXCAVATION CONTRACTOR; PLAN COMNISS~ON / BZA / BPW DOG, ET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERM]FI' #~ (IF APPLICABLE):
- - = · -" -
[:] SINGLE FAMILY
J~ TOWN HOME
(:] TWO FAMILY
# of units:.
Early Release
Permit: Y ~ N
PHONE
Lot Split:
-P: ,V :- ='T:
~ NEW STRUCTURE
ROON ADDITION(S)
_N
License #:
~ltemaUonal ResidenUal Code w/Indiana Amendments
Uniform Plumbing Code w/Zndiana Amendments
(MulU-Family Consb'uction Code)
~~.~: (Check all tfmt apply for the new
construcuon area)
[] CRAWLSPACE E~ POST & BEAM
~ SLAB [] BASEMENT
~ WALKOUT: y _N
OFF/CE USE ONLY: **********a
# Charged Re~
Reviews
Additional Fe~s