HomeMy WebLinkAbout05100110-ApplicationBUZLDER of
RECORD:
PROPERTY
OWNER:
LOCATION
& PRO3ECT
ZNFO:
City of tarred~Clay Township ~ Permit #
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, & Two Family: New Structures, AddiUons, Remodels, & Accessory Structures
5'II~EET AgDI~gSS ~ / ~ CITY . bi'ATE / ~-~ ZIP
NAHE PHONE FAX
ESTIMATED COST OF CONSTRUCtiON:
(EXCLUDING LAND VALUE)
FOOTAGE:
PLUMBING CONTRACTOR:
# of
Additions,
EaHy Release
4 ADDITION(S)
ACCESSORY BUILDING
[] DETACHED GARAGE
[] AI'rACHED GARAGE
[]] DEMOLITION
Which plumbing cocle~ will be applied to the construction:
~Intemational Residential Code w/Indiana Amendments
C3 Uniform Plumbing Code w/indiana Amendments
(Multi-Family ConstruCdon Code)
(Check all that apply for ~e new
d~dons~ remodels, ancot accessory stru~: ~1~,~13~dff ;~truction commences
· rot bin 180 days of the date of issuance of the building permit. ~d must be completed ~q~{~t~o£ the
time frames for beginning and completing co ,n~struct~n;.3 ~ ~ ~c* ::.!:'~c? Lt'~c:a~ COderS
I, the undersigned, agree, that any construction, reconstruction, ex~ememt, ~lccation, or ~t~_~l~i3~f~)~ p~ .,a~)l ~ i~t ~ iise of land or
slxucm~s ~q,u. ested by this application will comply with, and cor~ona to, all applicable lax~s~f?thg $~?'~i;. l~armel
India~- 1993 (Z~289) and amendments, adopted under authority of LC. 364' et ~eq, Gener~A/ss~nibt~'~ ~¢&;~ ~~
thereto. I filttber certiiy that only kitj:hen, bath, and floor drains are connected to thc sanitary sewer. I further c~a~ ~ cons~cBbli%~ltltt~ be
iD: ~ ~
. . Base Tr~specUons: # Charged Re-
unaer Slab Eev~ews
Site
~fOammunityServices (Date)
Cert. of Occupancy: .~_]_~__0
P.R.I.F.: ~ Additional Fees