HomeMy WebLinkAbout05110012-Application PERMIT APPLICATION
For Single Family, Multi-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER of
RECORD:
PROPERTY
OWNER:
LOCATION
& pRO3ECT
INFO:
SEWER
PROVIDER:
~ SINGLE FAMILY
[]] TOWN HOME
[] TWO FAMILY
# of units:
'~ MULTI-FAMILY
~ of Units:
[] RESIDENTIAL (For
Additions, Remodels, Etc,)
P - iE_- NF:RMATI:-'N:
STREET ADDRESS C~P¢ ~TATE
BUILDER'S EMML ADDRESS BEST METHOD OF CONTACT:
NjME PHONE, FAX
STREET ADDRESS
NAME OF UTILIT~ EXCAVATION CONTRACTOR- PLAN COMMISSION f BZA / BPW DOCKET
NUMBERS] TAC DATE(S}; AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S {IF APPLiCABLE):
NEW STRUCTURE
[] ROOM ADDITION(S)
[] PORCH ADDITION(S)
[] REMODEL
[] ACCESSORY BUILDING
C] DETACHED GARAGE
[] Alq'ACHED GARAGE
[] DEMOLITION
FAX
ZlP
CITY STATE ZIP
sE ON
s
PROVIDER: (EXCLUDING LAND VALUE)
Which plumbing construction:
Uniform Plumbing Code w/Indiana Amendments
(Multi-Farailv Construction Code)
Permit:Early Release ¢ /N Trusses:Manufactured ~Y// N constructi~FOONDATZON TYPE: (Check all that apply for the new
mp: ZY CJI CRAWLSPACE []] POST & BEAM
Lot Split: Y :~_N Sump Pu N ~ SLAB ~ BASEMENT
Does any part of the property lie within a special Flood designation area: Y ~/N WALKOUT: Y~_N
indiana - 1993" (Z~289) yard amendments, adopted under authority ot i.C. 36~7 et scq, Get, era[ Assemb y o[ tl~e State of ndiana and mtl Acts amendatory
thereto. I f~rthe~ cert~[y ~hat o~ly kitchen, bath and floor dxains are connected ~o tl~e sanitaW sewer. ! l'urther certify that the construction will not be
ed or occup until a ~c'a Occu, p m~c;~ has been is ued by the De p artrnent of Communit y Services , Carmel . Indiana .
:)ate
Filing Fees:
INSPECTIONS REQUIRED:
Base Inspections:
.
L~E?T 0
Reviewed/~¢~
~RV~CES
Chargea Re-
Reviews
Additional Fee~