HomeMy WebLinkAbout06030216 Application
City of Cannell Clay Township tY & ~ Permit #:(J6(J3D..::J.J h
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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NAME I/'
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STREET AD~~
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PHONE
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FAX
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STATE
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ZIP
Y'W3
PROPERTY
OWNER:
NAME
:JA~ 4p'b IYIt;t. Lov 11MA5
STREET ADDRESS
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LOCATION
&. PROJECT
INFO:
SUBDIVISION NAME
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TYPE OF CONSTRU~~ ,-
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OILY'"
F IMPROVEMENT:
EW STRUCTURE
OOM ADDITION(S)
RCH ADDITION(S)
R ODEL
o AC ESSORY BUILDING
ACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION
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MATION:
PHONE
FAX
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STATE
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ZIP
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SECTION
ZONING:
SQUARE
FOOTAGE:
ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE).$ om
PLUMBING CONTRACTOR:
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hy
KOUjh
Plumber's Indiana State License #:
Which plumbing codes will be applied to the construction:
o International Residential Code wI Indiana Amendments
o Uniform Plumbing Code wi Indiana Amendments
(Multi-Family Construction Code)
Early Release Manufactured FOUN.DA. TION TYPE: (Checktfl\'IIIY for the new
Permit: _ Y LN Trusses: _ Y LN construction ';;:ift \l~Q\r~~
Lot Split: _Y)eN Sump Pump: _Y LN =NU 0 BASEMENT ,
Does any part of the property lie within a special Flood designation area: _Y XN WALKOUT:_ Y--x"-N
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For singlfffi1);i.ay~ii&b F~y wM}rlg~.~ - l~iQP~l::,r~'?w~els, and/or accessory structures, this permit is valid only jf construction commences
within.!.&~~~{&t!::9~~fassWihC(itit:tKel\.:l1k.~am-g'Phn\\t';'and must be completed (Certificate of Occupancy issued) within 18 months of the
issuance cB.'te. ~tlass I s~~f$e~~iE~;;ua~t@.w:~ the General Administrative Rules of the State of Indiana (See 675 lAC 12) regarding expiration
CT _ <.. ~ I l'd l<'vt~Rw~,.!*gin~in and completing construction.
I, the undefJ~aGh~Q~.Mj4h:4bEb6n,' rctQps .~ . "'~~ff~emen ,rdC1cat~'O ,or alteration of a structure, or any. change in the use 01 land or
s[ruc[ure,s...r~~ F~iA\,1PRVFf.!ign/v4J~dmItI - iii! . f.:6h~11' ,a~plic ws of the State of Indiana, and the UZoning Ordinance of Carmel
Indiana J.I9)S~ ~H89) aha amel}~\~l"\t~~ fl.4~pted r au\horj,t C 36i!7 e ~, eneral Assembly of the State of Indiana, and all Acts amendatory
thereto. I t~er certify that only Kitchen, bath, an floorPr~s are ~ he sanitary sewer. I further certify that the construction will not be
use or pI d uoti Certificate of Occupa y has Wn issue y tfl epartmcnr of Community Services, Carmel, Indiana.
. 0 [4sIL tONSMucr1&.J. LU'_ 3/3", /Dro
re of t rized Print I Date /
*************************************~*******~*****************
Filing Fees: Q{13 9 L
PECTlON REQUIRED: /' / . /0 # Ch d
Base Inspections: _ 1.9 () J arge Re-
Under Slab " Reviews
)7 r--O
P RR,LFF~' / Additional Fees
;~~c2', 1"J'
Final
Cert, of Occu pa ncy:
,
Reviewed/Approved: Dept. of Commu ity Servic
S;Permits,/FormsIILP RESIDENTIAL '
Fee Received by: