HomeMy WebLinkAbout06040095 Application
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City of Cannell Clay Township \)J \(!"
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
permit#~~
For Single Family, Multi-Family, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
PROJECT INFORMATION:
Early Release ~
Permit: _Y _N
Lot Split:
BUILDER of
RECORD:
NAME
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PHONE 2 FF- Y70 0 Ff.:X
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CITY STATE ZIP
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BEST METHOD OF CONTACT:
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PHONE Ff.:X
PROPERTY
OWNER:
NAME
STREET ADDRESS
CITY
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/
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STATE
ZIP
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LOCATION
&. PROJECT
INFO:
LOT # 6)
SUBDIVISION NAME
SECTION
C
ZONING:
ADDRESS OF CQNSTRUcnON
:2 62.
SEWER UTILITY ~ WATER UTILITY /'
PROVIDER: C fje fA} () PROVIDER: L <>-.... n. c: ( (EXCLUDI 1
NAME OF UTIUTY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA I BPW DOCKET #n J"V.Jrra"'2
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABL~
, SQUARE"-- u__.
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TYPE OF CONSTRUCTION:
g/ SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units:
o MULTI-FAMILY
# of Units:
o RESIDENTIAL (For
Additions, Remodels, Etc.)
Manufactured
Trusses:
Sump Pump:
(Check all that apply for the new
o CRAWLSPACE
o POST & BEAM
~ASEMENT ~
WALKOUT:_Y~N
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this permit is valid only if construction commences
within 180 days of the date of issuance of the building permit, and must be completed (Certificate 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.
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alteration of a structure, or any change in the use of land or
structures requested by this application will comply with, and conform to, all applicable laws of the State of Indiana, and the "Zoning Ordinance of Cannel
Indiana - I993n (Z- 289) and amendments, adopted under authority of LC. 36~7 et seq, General Assembly of the Srate 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, Carmel, Indiana.
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Sign ure of Owner or Authorize Agent Pri"t Date
OFFICE USE ONLY: ** **** **** *********** ********* ** * ******* *****A*"*9*j*'^*****************
Filing Fees: + L.5 'f1I:
INSPECTIONS REQUIRED: . -, 2 /7 <()
,....-;:-::~ '" Base Inspections: _ J _ /, J
~pper ~ng C. ;'wer Foetin Under Slab - ~) 5'0
~ Cert. of Occupancy: .
~. ~ase Final Si I"> / 00
P.R.LF.: 0'-. t?
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# Charged Re-
ReVIews
Additional Fees
Reviewe Approved: Dept. of Community Services (Date)
S:PefmitsjFormsjILP RESIDENTIAL