HomeMy WebLinkAbout05100171-ApplicationRESIDENTIAL IMPROVEMENT LO( ATION PERMIT APPLICATION
For Single Family, Hulti-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
RECORD:
PROPERTY
OWNER:
NANE . ~ PHONE
FAX
~ L~-~-~'-~ SUBDMSION
]NFO: ADDRESS OF
SEWER UT~UTY ~
PROVIDER: (~.~'~ I~- V[,~. ~ ~-~ PROVIDER~v~' ~ (EXCLUDING LAND VALUE)
{IF
ATFACH ED GARAGE
[] DEMOI.T~ON
Early Release Hanufactured
Permit: Y t-/N Trusses: __Y ~/N
Lot Split: Y V/N Sump Pump: ~/~' N
Does any part of the property lie within a special Flood
Which plumbing codes will be applied to the construction:
~Intemational Residential Code w/Indiana Amendments
[] Uniform Plumbing Code w/Indiana Amendments
(Multi-Family Construction Code)
FOUNDAT~ N; : : (Check all that apply for the new
construction area)
issuance clare. Class I srrucrm-c
cimc frames for beginning and completing construction
I, cbc undersigned, agree rhar may construction, recomrruction, enlargement, relocation, or alteration of a
sr~-ucrarcs ~c~q.u. ¢srcd by this application ~ comply with, and conform to, all applicable laws of the State of E ~ Ordinance of
Indiana- 1993 (Z-289) and amendments, adopted under authority of LC. 36.7 et scq, General Assembl 11 Acts amendatory
thereto. I further cextffy that only kitchen, bath, and floor drains are connected ro the sanitary sewer. I further certify that thc construction will not be
used or occupied un~il a C~iEicate o£Occupancy'has been issued by the Department of Community Services, Carmel, Indiana.
A
Signature of Owner or Authorized AGent Print Date /
OFFICE USE ONLY: ************************************************************************
INSPECTIONS REQUIRED:
Under Slab
Base Inspections: ~
Cert. of Occupancy: ..~'"**-x ~0
P.R.I.F.: / ~ ~
Char~ed Re-
Reviews
AddiUon'al Fees