HomeMy WebLinkAbout05100182-ApplicationFor Single Family, Hulti-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
RECORD.
WNER:
NA~E PHONE FAX
ST.,er ~,~ss c~ ST^T~ Z~*
BUI~'S EMiL ~DRESS ~ M~OD OF CO~A~: ~ ~ ~ ~ ~ ~
& PRO3EcTL---~CA'I'Z~N1---'-- LOT ~ SUBDI~/ISION NAME SECTION~ _ ]-T ZONING..__~_ -- (/_//
INFO: ADDRESS OF CONSTRUCTION J S~UARE -- -, '
~ u~Lr~. ~~ J ES~M~D co~r OF CONSTRUC~O,.: ~ O O tg
E ~ _ . _1- :N: -.<-' - ,~EM --- :
C] TOWN HOME [] ROOM ADDITION(S)
[]] TWO FAMILY [] PORCH ADDITION(S)
# of units:__ [] REMODEL
[]] MULTI-FAMILY [] ACCESSORY BUILDING
# of Units: [] DETACHED GARAGE
[]] RESIDENTIAL (For [] AI-FACNED GARAGE
Additions, Remodels, Etc.) [] DEMOLITION
P - , .T~ -J:
EaHy Release
Permit:
Y ~N Manufactured
Trusses: Y ~N
- · . ~ _ ~ [] CRAWLSPAOE [] POST & BEAM
Lot bpdt. ____Y __N Sump Pump: v y__N [] SLAB -~ [~ASEMENT
Does any part of the property lie within a special FIood designation area: Y ~_~.,,~, ~, WALK,O.~ Y_ ~__~
I, the undersigned, agree ~ha~ an? c~nstrucdon, recons~oacdon, mt1,~-~cmea L raocation, or ~t~ ~mF~ ~ ~,an~ ch~*~h¢ us~ of la~cl~
sc~uctures requested by th~s applicauon wiIl comply with, and conform ~o, all applicable law~6~ ~h6 S~e o~/fifid ~h~ ~Sfffih~g ~~el
Indiana - t993" (Z~289) and amendments, adopted under anthori~y of I.C. 36-7 et seq, General Assembly of the Sm~/~nd ali Ac~s amenda~ory
thereto. I further cetx~ ~ha~ only kitchen, ba~h, and floor drains are connected to the sanitary sewer. I further certify that ~he constraction will no~ be
Signature of Owner or ~'uthorized Agent Print ~ Date
Whic-h ;,umbin. ~des ~ a~p?li~l tu ~e con~ucUon:
~ntemaflonal Residential Code w/Indiana Amendments
[] Uniform Plumbing Code w/indiana Amendments
(Multi-Family Consb'ucUon Code)
~[~[~L~: (Check all that apply for the new
construction area)
OFF[CE USE ONLY: ************************************************************************
INSPECTZONS REQUIRED:
Under Slab
Filing Fees:
Base Inspections: ~~ # Charged Re-
Reviews
Cert. of Occupancy:
P. R,I, F.: ~ Additional Fees