HomeMy WebLinkAbout06030077-Application
City of Cannell Clay Township
RESIDENTIAL IMPROVE
p_a.:"."ocfru Permit #: 0603 OtJ77
NT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, 1ft Two Family: New Structures, Additions, Remodels, 1ft Accessory Structures
BUILDER of
RECORD:
NAME
5a.me-
/, BESTMETHODOFCO'f1"ACfC'alled v'M :<?/n^ It;,
I< ~"C( f>">ivf!". CCr-\ ~ '1'frU/ j
PHONE )n-~-''l-I3'''-l FAX 31'7- 6'lS--bblO
~II 117 ~O'l-'i'ls-3
evv+
STREET ADDRESS
PROPERTY
OWNER:
BUILDER'S EMAIL ADDREpS
t:JS4". ",re
NAME At'\.
SlAv
STREET ADDRESS
c""...;t <io.t IN'<$
CITY
""".~ [?".'".... Cc.,.-.~I
STATE
;;;.AI
ZIP
'i(,03L..
LOCATION
1ft PROJECT
INFO:
LOT #
~2-
SUBDIVISION NAME
Fo ~ G-Y'<> V t.-
D;>) av,'v'<- C..r...J I.{{,03]
WATER UTILITY C I
PROVIDER: A-r.-.L.
SECTJON1- Zf!:~; c-&",!ric
;<..'~", SQUARE ~~P.I '2.'l0'
e;~ ,. ~e..~"-t) ..~OOTAGE: t-IC""iJ.t.. "3 . C't
ESTIMATED COST OF CONSTRUCTION_:Sl
(EXCLUDING LAND VALUE) '1ft '6' 0 i) 0
F
5f
SEWER lJTlLITY
PROVIDER:
NAME OF UTIUTY EXCAVATION CONTRACTOR; PlJ\N COMMISSION I BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'5 (IF APPLICABLE):
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT: PLUMBING CONTRACTOR: ~
o SINGLE FAMILY 0 NEW STRUCTURE 0 W neryev cR\\
o TOWN HOME 0 ROOM ADDITION(S) Plumber's Indiana State License #:
o TWO FAMILY 0 PORCH ADDITION(~ D ...,
# of units: ~ REMODEL !lot. +- e>d-h ro
o MULTI-FAMILY 0 ACCESSORY BUILDING E~InOO.GQt-II@;.PPlI~tI@N1struction:
# of Units: 0 DETACHED GARAGE SubjQ$tiiitlifrl.ticliiar'R~5ki,,"tlllpcOikl..\QlI8iana Amendments
~ RESIDENTIAL (For 0 AlTACHED GARAGE of ;~[8t8 'r'C' 1.,0:';1 Code. .
Additions, Remodels, ~EtC.) 0 DEMOLITION DE'Pr... .f",'1'.f9 J:?1 ir.fl,IIJP\?'1''r.9,~~w.l!.~\df\~Ea SAme ndme. nts
- , (MullI-FamHyC6Rstmct'I>n'Cooe)" ,,' .
PROJECT INFORMATION: ~ CITY Ci ('APM I CJ '..\",::'; ';;'J"'HIP;
E I R r f ct d FOUNDA TV: (Check all'nlafapplY for the new
ar y _ e ease . anu a ure ~ construction Ii '{'I ~.
PermIt: Y ~ Trusses: Y - per
. - - - 0 CRAWLSPACE 0 POST & BEA C&<il
Lot Split: _ Y N Sump Pump: _ Y _N 0 SLAB :><:C. BASEMENT
Does any part of the property lie within a special Flood designation area: _ Y LN WALKOUT:_ Y_N
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this.~mit..jS"'vahchm)x-~-c.Rri~~Hor:~o~mences
. within 180 days of the date of issua~ce of the ,building permit, and m~s~ be c~mpleted (Ccrtifica~~ol'<?~a~i~!d)J'..XE!Iin~~c&it~!')o~ th~
Issuance date. Class I structure permIts are subject to the General AdmInIstrative Rules of the Sta~e, Of~diirla.(S@e.675~AE-I'2)Tegarll;l\~g ~~IratIon
time frames for beginning and completing constructlo\::J t i \ \l
I, the undersigned, agree that any construction, reconstruction, enlargemcm, relocation, or alteration of~~ cture'?I PW chao)i:e WrtR~ use (lan -L~r
structures requested by this application will comply with, and conform to, all applicable laws of the Stat~ Ff .ana,MAtthel'Z~ir4}ttjffiina d9oflQ.:armel
Indiana -]993" (Z-289) and amendments, adopted under authority of r.c. 36-7 et seq, General Assembly lilfJh ate of Indiana, and all Acts arhthdaMry
thereto. I further certif hat only kitchen, bath, and floor drains are connected to the sanitary sewer. I f4J h tertify that the cons.ttu.ctio~(ndr be
used or pied a Cerriiicatc of Dee up a y has been issued b~1::7es~c:mmunit Services. Carmel. Indiana~/wlo)
ignature of Owner or Authoriz Print Date
OFFICE USE ONLY: * *************************************************~~***************
Filing Fees: {;;2, ti!- '/ .)
INSPECTIONS REQUIRED: I
Base Inspections: '/ () '7 () 0 # Charged Re-
ReViews
Cert. of Occupancy: 57 5'0
Upper Footing
Lower Footing
Under Slab
~U9h Ii!>
:1
'/
Meter Base
~
Site
"03 a
Revi wed/Approvea: oept. of Community Services (0 te)
S:Permits/Forms{llP RESIDENTIAL
P.R.I.F.:
Additional Fees
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&7
020'