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HomeMy WebLinkAbout06020119 Application u\L'-. 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: )/ ,'v' (-< fj ;C;:)e /<13 STATE ZIP (,. ~p. Yt2',-U NAME 'H 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. '/? t. c:.la c.~ 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