HomeMy WebLinkAbout04100186 ApplicationOWNER:
& PRO3ECT
ZNFO:
Multi-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
PHONE FAX
ADDRESS OF CONSTRUCTION -
SEWER UTILITY C ~.l---x3 .~-_ WATER UTILITY ~__.~t C~ l ~.~ EE'~MATED COST OF CONb-TRUCTION:
PROVIDER: [ ~-~ {.&~ ~ PROVIDER: ~L~ ~.~ (EXCLUDING LAND VALUE)
NAME OF UT[LITY EXCAVAT[ON CONTRACTOR; PLAN COMMISSION / 8ZA / BPW DOO~'T
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEFI~C PERNTF #~ (IF APPLICABLE):
mOT^ : 12. f 0
ooo
F'l TVVO FAMILY
# of units:
[] MULTI-FAMILY
~ # of Units:__
~ RESIDENTIAL (For
Additions, Remodels, Etc,)
CZ} NEW STRUCTURE
.~ ROOM ADDITION(S)
PORCH ADDITION(S)
~ REMODEL
ACCESSORY BUILDING
DETACHED GARAGE
ATTACHED GARAGE
DEMOLITION
·, Manufactured
Permit: Y LN
Plumber's
Which plumbing codes
[] Uniform Plumbing
(Multi-Family Construction Code)
:: - DA N TYPE: (Checkallthatapplyf~
construction area)
[] CRAWLSPACE [] POST & BEAM
LotSplit: ~} SLAB ~ BASEMENT
DoesanypartofthepropertyliewithinaspecialFIooddesignationarea: Y_~__N WALKOUT: Y ~[_N
ory sttuctur~rmit is valid only ff cons~
~~~ cilag pcnm't, and must be completed (Certificate of Occupancy issued) within 18 months of the
'~ the Genial Aclmlms~ative Rules of the State of Indiana (See 675 IAC 12) regatfling expiration
time ftame~ for beginning and completing construction.
I, the under~igned~ agree that any construction, reconsttuction, enlargement, relocation, or alteration of a structure, or any c~ .t~ .ge in the use of land or
structures re~u. ested by this application will comply with, and conform to, ~11 applicable laws o[ the State of Indiana, and the Zoning O~:linance of Cannel
Incliana- 1993 (Z-289) and amendments, adopted under anthorit7 of I.C. 36-7 et seq, General Assembly of the State o£ lndiana, and all Acts amendatoW
thereto. I £u~aer cerdty that only kitchen, bath, and floor drains are connected to the sanitary sewer. I further certify that the con~tenction will not be
ased ~r ~e/u~ed unti~ ~-a~ c/~ ~up~c~has been ~ssued by the Depm~twnent ~f ~mmtmky ~erv~e*~ carme~ ~ndian~
~tgnat~4r~of Owner or Authorized Agent Prin~ Date
-._. FIhng Fees.
INSPECTZON~IJ~ fOR CONSTOl JCa'lP~ ~,3..
Upper Footing Lower~o~i~iitg'~211ti~li~ wm~ al~ reguladon~ --'-~.,.~' ~ ~ Reviews
-~e ~nd Looal CTC~t._~ of Occupancy: - · L/ -
iNDiANA