HomeMy WebLinkAbout06020119 Application
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City of Cannell Clay Township Permit #: d t., O")..t) , I ~
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER of
RECORD:
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STATE ZIP
(,. ~p. Yt2',-U
NAME
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PHONE
!Y6 ~2 7(2
FAX J '/(- ,/221
BUILDER'S EMAIL ADDRESS
.0' / / BEST METHOD OF CONTACT: ~ .
l'lf;:;tp,d ' G-- tf::; - _"'/ I
PHONE FAX
PROPERTY
OWNER:
NAME
STREET ADDRESS
CITY
STATE
ZIP
CTIC w p
/1:
Cf:
SECTION /
ZONING: AJ
~~Li
LOCATION
&. PROJECT
INFO:
LaT# Yl SUBDIVISIONNAME)f",^ hrA
ADDRESS OF CONSTRUCTION j /> I' L
}?TJ NO V\. r>
WATER UTIUTY <l~ 'l. , \ I ~
PROVIDER: (tx- jL /'" C (
SQUARE \
FOOTAGE:
SEWER UTIUTY
PROVIDER:
EST1MATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE) '2/)- <J cJ (/, e) (7
NAME OF UTIUTY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW OOCKET
NUMBERS; TAC DATE(S); ANO/OR COUNTY WELL AN!,/O,,^SEPT1C PERMIT #'S (IF APPUCABLE): I r, '"
< ,,' \ . '/'" A ""
. .J \f~\\ Q A
TYPE OF CONsrRUCTIO~:<'<\:il \TYP FIlM ROVEMENT: PLUMBING CONTRACTOR: I" ~~..
~INGLE Ft'-M!~Y, ~ ,:' .;, \\<~>/ \ \ Ew STRUCTURE ;; "" ",-( c:: Y0-.1' ~+ '" ~~
8 ~~NF~~I~~20::;:.:;:"'>/ ')~fJ~8'~.\\.~f!OY.~t~gD~o~~~J) Plumber's Indiana State License #: ~~.'l2.. ~~
# of Unlq;:\ . 1:" 0 YeMO~EL 10'>- rife) r "8:,. 'Y.>
o MULl1-FAM(~'f If \;\6 -E'J ACCE~ORY BUILDING Which plumbing codes will be applied to the construction: 01~
# of Units,: , 1,1 _ ~......-- 0 n""'" HED GARAGE n In"" ti I R 'd ti I C d II d' A d ts
____ .........-':'".:L=.11"\ ~_ma ona eSI en a 0 e w n lana men men
o RESIDENTI(\b,(\O!..~ /E'J ATTACHED GARAGE
Additions,,~.\emodels, Etc,) ~ 0 DEMOUTION 0 Unlfonn Plumbing Code w/Indiana Amendments
~ (Multi-Family Construction Code)
PROJECT INFO~MATlON:
Early Release <./
Permit: _Y _N
Manufactured
Trusses:
_~N
FOUNDATION TYPE: (Check all that apply for the new
construction area)
Lot Split: _Y \/N Sump Pump: -0'_N
Does any part of the property lie within a special Flood desi
, .", ,.~ ,. ,"', ,.~.,", ~','-,M r.., ;..l:"""."~
C9-'CRAWLSPACE
Gl-SLAB
nation area:
I
Y
~.
o POST & BEAM
o--B'ASEMENT
WALKOUT:
y ---N
Fo~ Si?gle Family and~t~~}~Y:~(~Y~,~~li~)~~tfe.me~~fl~essory structur~. this permit is vali~ only if c~ns~ruction commences
WIthin 180 days of the date of lSS~~.c.e Qf die bUlldm~~~t, anli~Htst'te completed (Certificate of Occupancy ISSUed) WIthin 18 months of the
issuance date. Class I structure perinitS:are)siilfj&t!t8t;lie!~~dministrative Rules of the State of Indiana (See 675 lAC 12) regarding expiration
DEF'T or COMI~U:,,*fi>{ot'l€ifilljl~ompletingconstruction,
I, the undersigned. ag:t;~.~; ~ constlJ:lltq9.~ ~f.( onptjUftiRE\v~t~f!jion, or alteration of a structure, or any change in the use of land or
structures requested by4~ app~rtidn.~idpl'rWid{,tm(lcbnfuhft 't~.'alhlpp:a~able laws of the State of Indiana, and the "Zoning Ordinance of Carmel
Indiana - 1993" (Z,289) and amendments, ado~~Ahority of I.c. 36,7 et seq, General Assembly of the State of Indiana, and all Acts amendatory
thereto. I further certify that only kitchen, bath, and floor drains are connected to the sanitary sewer. I further certify that the construction will not be
used or occupied until a Certificate of Occupancy has been issued by the Department of Community Services, Cannel. Indiana.
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Print(
'Z. -Z /~Q b
Date
OFFICEUSEONLY:************************************************************************
Filing Fees: ';2f1- L (;.Q
INSPECTIONS REQUIRED: .' /
f.:_ - -= Base Inspections:"..Z /-. '/. ~ () # Charged Re-
~per FDot~~FoO~9) Under Slab - /' /() ReViews
~9h In ~_ete._~~_'';';'-) Co.. of -""'Y' (~! u~ "",__
c:~.;~;SeN .~ P'~F'~' W~L"'",J ~3 ~/7~
Reviewed/Approved: Dept. of Community Services (Date) '- ~ ~ CL-.Ji.J j7 U OJ q "( '--'
S:....ml"'fonn~ILP RESIDENTIAL Fee Received /j ~" II