HomeMy WebLinkAbout06050074 Application
City of Cannell Clay Township
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
CIIA
Permit #:
0& r;6 007l.J
For Single Family, Multi-F
New Structures, Additions, Remodels, lit Accessory Structures
BUILDER of
RECORD:
NAME
Shannon Hinshaw
PHONE
FAX
cm
STATE
ZIP
Indiana lis IN 46250
BUIL~ 3tN06-2941 Fox 317-842-3389 BEST METHOD OF CONTACT
PROPERTY
OWNER:
NAME
PHONE
FAX
STREET ADDRESS
cm
STATE
ZIP
LOCATION
lit PROJECT
INFO:
ZONING:
SQUARE I) H if-
FOOTAGE: 0\ / '-f j
TYPE OF CONSTRUCTION:
o SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
fl.U. # of units:
1,'fI\ MULTI-FAMI~Y
# of Units:
o RESIDENTIAL ( r
Additions, Remodeis, Etc.)
TYPE OF IMPROVEMENT:
Q6 NEW STRUCTURE
b' ROOM ADDITION(S)
o PORCH ADDITION(S)
o REMODEL
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION
ESTIMATED COST OF CONSTRU9fIO~: /) I. (J A
(EXCLUDING LANO VALUE) i{fJ f (/) If ,/ Ut
ftt{}fW(}jjjj
'0 I',~
IfJILL, 0,. ~ ~ 'Il
er's In . na State license #: * ~'? ;:e'8, ,0'".
/ ()!)J)() () 51 ':]1\' ,"-1)-
;'J",,,
Which plumbing codes will be applied to the construction: Fb
o International Residential Code w/lndiana Amendments
~ Uniform Plumbing Code w/Indiana Amendments
(Multi-Family Construction Code)
SEWER UTILm
PROVIDER:
NAME OF UTILTIY EXCAVATION CONTRAcrOR; PLAN COMMISSION I BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE):
PROJECT INFORMATION:
Early Release .'
Permit:
FOUNDATION TYPE: (Check all that apply for the new
_y' X"N ~r~~~~~ured X Y _N construction area)
v V 0 CRAWLSPACE
Lot Split: _Y ~N Sump Pump: _Y ~N 0 SLAB
Does any part of the property lie within a special Flood designation area: _Y XN
o
o
POST & BEAM J
BASEMENT
WALKOUT:_Y_N
For Single FamilY~iT.wq ~il.Y ~WiA1.ciiB_~JU1d/or accessory structures, this permit is valid only if construction commences
within 180 days tif~~R.bJurIM'dntr~\}h~i ~II'M!Md.lnust be completed (Certificate of Occupancy issued) within 18 months of the
issuance date. ClaStJ9j8CC:UO:"q>am\Ji.U~~~ht8' KlIninistrative Rules of the State of Indiana (See 675 lAC 12) regarding expiration
'"", of State and L~~OodeS"pr beginning and completing construction.
I, the unde.rsigned, ~r~~I'tl#wlifv-'rD'" ~E' 6egnr, relocation, or alteration of a structure, or any change in the use of land or
stI}.1ctures requestecfoMt"this a~.lkabbn'Mlll:b~ X '\~~9' an co t ,.all applicable laws of the State of Indiana, and the "Zoning Ordinance of Carmel
Ipdiana -1993" (ZOf1))fnf1)fn~iIcrl: ;~ aT " :tt;'~7 et seq, General Assembly of the State of Indiana, and all Acts amendatory
thereto. I further certify that only kitcheO\.J::rr\r~oor drains are connected to the sanitary sewer. I further certify that the construction will not be
used. r occupied until a er.tj{jcate ofB~c'1fpancyh'as been issued by the Department of Community Services, Carmel, Indiana.
I fjj.I}IJNOA/ IlIAISf!I}JAi 6'- /- W
Print Date
OFFICE USE ONLY: ****** *************** *~**************** ****f***** **********************
i1-Filing Fees: \.j;> en 3 ,SO
PECTIONS REQUIRED:' /17 7 K'O
Base Inspections: ..&. ' v # Charged Re-
Lower Footing 5" 60 ReViews
Cert. of Occupancy: '3 .
P.R.i.F.: 5" -:J... 7, 00 Additional Fees
~~j5;)'1,50
Site
(Date)
ReviewedjAppr e: ept. of Community Services
S:Permits/FormS/ILP RESIDENTIAL
Fee Received by: