HomeMy WebLinkAbout06040122 Application
'i:ity of Cannell Clay Township \ylo~ DWLtD I ~;l, Permit ~
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER of
RECORD:
NAME
1:.
PHONE
'2 >F7700
FAX
20)........... Cfy Vii
LOCATION
&. PROJECT
INFO:
t~
('10 "" <
PROPERTY
OWNER:
NAME
PHONE
FAX
STREET ADDRESS
CITY
STATE
ZIP
LOT #
ZONING:
;;/
SQUARE Y .-
FOOTAGE: I Lf 1
SEWER UTILITY
PROVIDER: C f( w.o
WATER UTILITY
PROVIDER:
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA I 8PW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'5 (IF APPLICABLE):
TY~IMPROVEMENT:
NEW STRUCTURE
o ROOM ADDITJON(S)
o PORCH ADDITJON(S)
o REMODEL
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION
i JI i;,
II' i</ A II' .!ii
J{I n()(' , I ,.1
Plu ber's Indiana state ~ense #: - v ! I! ! /i
/ U / 7/7 7 ---.-------.-..j l'::)!
-- '
Which plumbing codes will beai}:Jptied,to.the construction: i
---.--. I
g..zt1ternational Residential Code wI Indiana Amendments
o Uniform Plumbing Code w/lndiana Amendments
(Multi-Family Construction Code)
TYPE OF CONSTRUCTION:
~NGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units:
o MULTI-FAMILY
# of Units:
o RESIDENTIAL (For
Additions, Remodels, Etc.)
PROJECT INFORMATION:
FOUNDATION TYPE: (Check all that apply for the new
Early _Release c./ '.Manufactured ~ . ,., construction area)
PermIt: _Y _N Trusses: W N TIO"'"'
_ R NSTf\WC II"J CRAWLSPACE 0 I;OST & BEAM
lot Split: _Y ~E~lhiiilihfpC _Y" ,,-mrr'a(gulatiO~LAB ~ASEMENT
toto om ha[lltE,lWlt""". ~ ~
Does any part of the proper19llAllWmn a li'd....I1JE:~ation area: . . y.,. , N WALKOUT: Y. N
For Single Family and Two Famil~~~Fi@(i}MbiUJrMJif.'{n a ~s~JJ[~ /iQ;llctures, this permit is valid only if construction commences
within ISO days o!the date of is;!r.Ilite of t ~Ril4~t~~Vnif(])W~r(Cectificate of Occupancy issued) within IS months of the
issuance date. Class I structure t8~ .Q 'u~.' ttt\'t~t:;ener clministrative Rules of the State of Indiana (See 675 lAC 12) regarding expiration
time fra~ ning 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 'Aill comply with, and conform 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 r.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 ~~ occupied until a C~rtificye of Occupancy has been issued by the Department of Community Services, Carmel, Indiana.
. 7: ~ /? L- G-fiu Ct:: <{- - (j 6
Sign ure of Owner or Authoriz Agent Prfut Date
~FFICEUSEONLY: ************************************************************************
\ Filing Fees: 8() i ')' 0
-lNSPEcnON QUIRED: --., ..--7--7
~ c--,... Base Inspections: c;-/ . / /. < O. # Charged Re-
I Upper Foot~g lower Foo Under Slab r--') -c ReViews
~~ Cert. of Occupancy: ~ - 2-.0
\ Rough In~se Final Site P.RJ.F.: /;2 6/- 00 Additional Fees
c23
\
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'wed/Approved: Dept. of Community Services (Date)
ts/FormsjlLP RESIDENTIAL