HomeMy WebLinkAbout06050116 Application
BUILDER of
RECORD:
UI&' ~ oJ-
City of Cannell Clay Township ~ Permit #O~D 5 () 110
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATI
For Single Family, Multi-Family, &. Two Family: ' ssory S ructu
NAME
Shannon Hinshaw
lllson Polnte Blvd. #200 CITY
PHONE
STREET ADDR
BUILrpfifRilL3f1-806-2941 fox 317-842-3389
PROPERTY
OWNER:
NAME
PHONE
STREET ADDRESS
CITY
LOCATION
&. PROJECT
INFO:
SEWER lJTIlITY
PROVIDER:
", ''',
NAME OF UTILITY EXCA TION CONTRACTOR;'PJ.:AN_COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL Ar-{ , SEPTIC PERMIT #'5 (IF APPUCABLE):
. \,
TYPE OF CONSTRUCTION:
Q( SINGLE FAMILY
o TOWN.HOME
o ~0;FAMILY
o \ MU~:~%jL Y "
# of its:: \
o RESIDEj\inAt (For /
Additions, R~mo'cieIS, Etc
o Uniform Plumbing Code w/Indiana Amendments
(Multi-Family Construction Code)
PROJECT INFORMATION:
Early Release Y X Manufactured FOUNDATION TYPE: (Check all that apply for the new
X construction area)
Permit: _Y _N Trusses: _Y_N
X 0 CRAWLSPACE
Lot Split: _yLN Sump Pump: _Y_N 0 SLAB
Does any part of the property lie within a special Flood designation area: _Y-2lN
o
%(
POST & BEAM
BASEMENT ;I
WALKOUT:_Y 4N
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 IS 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 Carmel
Indiana - 1993" (Z~ 289) and amendments, adopted under authority of LC. 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
use or occupIed until a ertificate of Occupancy has been Issued by the Department of Commumty ServIces, Carmel, Indiana
, ) tV!IJA!A!{)/J ;!I/ilJl/-l/}/A1 s: 8-Q-&
Authori ed Agent Print Date
OFFICEUSEONLY:**************************~**********************~77**~~***************
FIling Fees: (f . U
NSPECTlONS REQUIRED: ") r'1 fO
___ ~-- Base Inspections: V"- I . /
Upper FootiM CLower Footi.!!9=> Under Slab 5"3 , 50
Cert. of Occu pa ncy: 7fI
00ug~e~ Final""'- ~ P.RJ.F.: If> --5- c?1oo
II/lob 'f (JO
u-
# Charged Re-
ReViews
Additional Fees
Reviewe Approved: Dept. of Community Services
S:Permits/forms/llP RESIDENTIAL
(Date)
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