HomeMy WebLinkAbout06010067-Application
City of Cannell Clay Township Permit #" o6tJ II) /)'1
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
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BUILDER of NAME
RECORD: f;
STREET ADDRESS
aUILDER'S EMAIL ADDRESS
PROPERTY NAME
OWNER: ~
STREET ADDRESS
PHONE
FAX
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STATE
ZIP
BEST METHOD OF CONTACT:
PHONE
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FAX
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STATE
ZIP
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LOCATION
&. PROJECT
INFO:
LOT #
SUBDMSION NAME
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SECTION
ZONING:
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ISSION / BZA / BPW DOCKET
Emc PERMIT #'5 (IF APPUCABLE):
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SEWER UTIUTY
PROVIDER: 5e. 'C-
NAME OF UTIUTY EXCAVATION CONTRACTOR; P
NUMBERS; TAC DATE(S); AND/OR COUNTY J.
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ADDRESS OF CONSTRUCTION Ie T,{oJ tLJa-
WATER UTIUTY -r-,,'A I
PROVIDER: ....t-- ......,<.-. ttAe.. /
PLUMBING CONTRACTOR:
Plumber's Indiana State License #:
o
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Which plumbing codes will be applied to the construction:
o International Residential Code w/lndiana Amendments
o Unifonn Plumbing Code w/lndiana Amendments
(Multi-Family Construction Code)
_Y_N _Y_N
o CRAWLSPACE
Lot Split: _Y _N Sump Pump: _Y _N 0 SLAB
Does any part of the property lie within a special Flood designation area: _Y_N
FOUNDATION TYPE: (Check all that apply for the new
construction area)
o POST & BEAM
o BASEMENT
WALKOUT:_Y_N
For Single Family and Two Family dwellings, additions. remodels, and/or accessory structures. this permit is valid only if construction commences
within 180 days of the date of issuance of the building permit, and must be completed (Certificate of Occupancy issued) within 18 months of the
issuance date. Class I struCture permits are subject to the General Administrative Rules of the State of Indiana (See 675 lAC 12) regarding expiration
time frames for beginning and completing construction.
I. the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alteration of a structure, or any change in the use of land or
structures requested by this application will comply with, and conform to, all applicable laws of the State of Indiana, and the "Zoning Ordinance of Carmel
Indiana - 1993" (Z~ 289) and amendm s, adopted under authority of I.c. 36~ 7 et seq, General Assembly of the State of Indiana, and all Acts amendatory
thereto. I fu certify that only kite en, bath, and floor drains are connected to the sanitary sewer. I further certify that the construction will not be
used or occup d . a Certificate {Occupancy has been issued by the Department of Community Services, Carmel, Indiana.
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Signature of owner or Authorized Agent ~,_....--Print~ Date
OFFICEUSEONLV:**************Zfj;* *******7* * ***********************~~*****************
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INSPECTIONS REQUIRE ~.' 77, ;Z-5 # Charged Re-
Upper Footing Lower Footing Und Slab ~;.5.3 . S- 0 Reviews
Rough In Meter Base ~ Site
~ P.R.I.F.: - Additional Fees
/7 TOTAL, 4t';z.s~ ~ a .
Fee~0:.::!f () 11/&t c4r' ~ 1 jtJb
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~f>lo.Nfift.SJ ~. 11,;),00(,
Reviewed/Appro : Dept. of Community Services (Date)
S:PermIts/FonnslILP RESIDENTIAL