HomeMy WebLinkAbout05100163-Application Township
IMPROVEMENT LOCATIONPERMIT APPLICATION
For Single Family, Multi-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
RECORD:
PROPERTY
OWNER:
LOCATION
& PRO2ECT
INFO:
BUILDER'S EMAiL ADDRESS
S~ET ADDRESS
STATE
BEST MEITtOD OF CONTACT:
PHONE
FAX
FAX
'-1 TOWN HOME
TWO FAMILY
# of units:
[] MULFJ-FAMILY
#of Units:
[] RESIDENTIAL (For
Additions, Remodels, Etc.)
~NEW STRUCTURE
ROOM ADDITION(S]
[] PORCH ADDTHON(S) ~
[] REMODEL --
[] ACCESSORY BUILDING xWh/~ch plumbing codes will be applied to the c
__[~ DETACHED GARAGE ~ Zntemaflonal ResidenUal Code w/~ndian;
U ATTACHED GARAGE
[] DEMOLWION /~ Uniform Plumbing Code w/Zndiana Amendments
Manufactured
Permit: Trusses:
Lot Split: Sump Pump: .
Does any part of the ~ lie within
(Check all that apply for the new
POST & BEAM
time frames for beginning and completing c ; expiration
I, the undersigned, agree that any construction, reconstruction, enlargement, rdocation, : in the use of land or
~rUd~a _r~Sl~.. ~te~ ~y' this, appli~tion will, comPly w~,'th, and co.fo .rr9 to, all .pV~ca5[e laws of the State o[ Indiana, md the 'Zoning Ordinance of Cannd
th,..,,,,.,,~ - .~-~o t~-zo~/aha araenoments, aaoptea uncter aumorit7 ot i.e. 36.7 et seq, General Assembly of thc State of indima, md ali Acts amendatory
exeto. I further certEy that only kitchen, bath, and floor drains axe connected to the saoJtary sewer. I further eert~7 that the construction will not be
[ u~d~r~c~iedunti~a~e~c~e~£~pa~yhasbeenis~uedbyth~De~ar~m~ e~t~f~?mmum~se~d~n~
OFFIC[ U$£ ON . *************************************
INSP~:CTION$ R£qUlRED: Rlin9 ~ees. ~
Under Slab Base Inspections: fid # ChargedRev~ewsRe-
Cert, of Occupancy: ~