HomeMy WebLinkAbout06030085 Application
City of Cannell Clay Township Permit #: tJ a, IJ 500 ~
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER of
RECORD:
NAME
CI1f2-f'lf'-
FI(2.G Dspr
STREET ADDRESS
2.
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PHONE
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OTY
C'" ~"" (
FAX
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C"V1i-
STATE
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ZIP
'-It OJ2-
BUILDER'S EMAlL ADDRESS
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BEST METHOD OF CONTACT:
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PROPERTY
OWNER:
NAME
I'" ij< e
f'<.v.<' :era
PHONE
(.,7C,-fj{,IiS-
FAX
STREET ADDRESS
7 '1 "ILl
J~ "tiL!l tv>,(
CITY
fr~ 1'/&" .......
STATE
INP" I,v
SEcnoN/T..vl'lp~l
5 or T /) IZ /))
ZIP
Lf" 2- >-6
LOCATION
& PROJECT
INFO:
LOT #
SUBDMSION NAME
ZONING:
ADDRESS OF CONSTRUCTION
IIU)l..-
TOV"'le-
fl."'/I'.f
SQUARE
FOOTAGE: 35>.0.0
SEWER UTILITY
PROVIDER:
WATER UTILITY
PROVIDER:
ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE) IV
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA 1 BPW DOCKET I (_ . . /7, C.
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE): ~ .
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT: PLUMBING CONTRACTOR: _L.~ J__
~ SINGLE FAMILY 0 NEW STRUCTURE , re' df:1'rU
o TOWN HOME 0 ROOM ADDmON(S) Plumber's India tate ~~:i W is \ \
o TWO FAMILY 0 PORCH ADDmON(S) \ \ I '-'= .
# of units: 0 REMODEL
o MULTI-FAMILY 0 ACCESSORY BUILDING ,pm' to"''U'''~on
#~~~ 0 0 \
O DETACHED GARAGE International tia 0 e w/Indiana Am ts
RESIDENTIAL (For 0 ATTACHED GARAGE
Additions, Remodels, Etc.) W DEMOLmON 0 en ments
PROJECT INFORMATION:R~L
c t;lI "",...", '. FOUNDATION (C~eck all t~atapplvforthe new
EarlY.Release Sub'". ,~~nufatt!!n;d:;:"",,~ '''-'' construction area)
Permit: _Y _N j~CTrusses;Jh,n~ ""',Y,' n! !N;TiON
. Oi S!c,.. . '...6 ~il/:, .0'1 ro-, , , 0 CRAWLSPACE 0 POST & BEAM
Lot Split: _Y -.DlP!PT .surh~!ump:Loc~: ':: Y ''''IN<itlons 0 SLAB 0 BASEMENT
Does any part of the pQ/iJilft0~~~~t~:~~PbCiial/f!081~i~i!lt'ation area: _Y _N WALKOUT:_Y_N
For Single Family and Two Family dwellings, r.~f\it6]l~~daerOv~r~'~ory structures. this permit is valid only if construction commences
within ISO days of the date of issuance of the bli~t. and mu~~ bl!d0lf{pleted (Cenificate 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.
1, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alteration of a structure, or any change in the use of land or
strucrures requested by this application will comply with, and confonn to, all applicable laws of the State of Indiana, and the "Zoning Ordinance of Carmel
Indiana -1993'" (Z~289) and amendments, adopted under authority 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 funher certify that the construction will not be
used or occupied until a Certi!icate of Occupancy has been issued by the Department of Community Services, Carmel, Indiana.
..-"'1.-.. --- ~ r>/}(1..Jl... rE.. C.d?-!: '- '?-- '3~ob
Signatu~ of Owner or Authorized Agent Print)' Date
OFFICEUSEONLY:************************************************************************
Filing Fees:
Base Inspections:
Cert. of Occupancy:
Rough In
Lower Footing Under Slab
Meter Base Final 5J
P.R.LF,:
../
~ # Charge~Re-
Reviews
V~ '
'f'" Additional Fees
, INSPECTIONS REQUIRED:
Upper Footing
~~\nrN'~& 'n\llAI:~ \I,,~<<.J!'
Revie /Approved: Dept. of Community Services (Date)
S:Permlts/Forms/ILP RESIDENTIAL
~OTAL:
Fee elved v: ~ I(l, Iv,- !!aMI
3/!5/0&