HomeMy WebLinkAbout05100204-ApplicatonBUZLDE~
RECORD:
PROPERTY
OWNER:
PHONE
CITY STATE
BEST METHOD OF CONTACT:
CONSTRUCTION
~q~ ~ g>~ ~ ~,~/.
Addres~ of Sheti Building (If dllferent than Addres~ of Construc~on)
ZiP
SUTFE # (If Applicable)
Lot # and Subdivision (if Applicable)
ZONING:
SCOPE(S) OF O FDN O STR ~ ARCH ~ MECH 1~ PLUM SQUARE
~ t~O RELEASE: ~ ELEC 4~SPKLR OTHER(S):__ FOOTAGE: I
~ *~ PROVIDER: /~ i~/~'~ C~ (EXCLUDING LAND VALUE) ~ %~'~c~c~:~
~mN DOO(ET ~UMBERS AND/OR
~ND/OR SEPnC ~ERMrr # S (if Ap~mab~) ~J/A
· -~4P- _- NT: ' _0 F-: - -T~. N:
[] NEW STRUCTURE Early Release Manufactured
C~ ADD,DON Permit. Y )~N Trusses: Y_,~N
0 iN
[]
0 ~
CRAWL SPACE
BASEMENT
CELL TOWER CO-LOCATE
DEMOLVflON ~ ~ o O~t~o-
Rules of ~he State of I~dia~ (See 675 L~C 12) regarding expiration time frames for
Services, Can~el. Indiana.
~t only
a Cut~'mte o£
Date
REQUIRED:
Lower Footing Under Slab
Meter Base ( Site
Filing Fees:
# Charged Re-
Base Inspections: Reviews
Addition~lFees
by: