HomeMy WebLinkAbout06060077 Application
. City of Cannell Clay Township vJ Co. ~ Permit #: fJ(, Draco ') ')
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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STREET ADD,\ESS "J.l..
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PROPERTY
OWNER:
BUILDER'S EMAIl ADDRESS
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STREET ADDRESS
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FAX 84 d-"8~lo~
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CITY
STATE
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ZIP
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, BEST METHOD OF CONTACT: . \
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PHONE FAX
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CITY
STATE
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ZIP
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LOCATION
& PROJECT
INFO:
LOT #
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SEmON
ADDRESS OF CONSTRUCTION <":> _ ,\ n '
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0- "" WATER UTILITY C OG,~qo?",
vT\<.I..0,y PROVIDER:Cl-r~\
SEWER UTIUTY
PROVIDER:
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ZONING: \
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SQUARE 1:::0.1 t:-'
FOOTAGE: -.) I \.DJ
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NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; lAC DATE(S); AND/OR COUNTY WEL lOR SEPTlCPERMIT "5 (IF A P
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o
Early Release ~ Manufactured / FOUND~TION TYPE:
P 't Y N T Y N constructIon area)
erml : russes:
- / ---r - 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 \L-N
(Check all that apply for the new
o .)'OST & BEAM
~BASEMENT ~
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.
t, 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 - I993~ (Z- 289) and amendments, adopted under authority of l.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 arc connected to the sanitary sewer. I further certify that the construction will not be
sed or cupied u i C .cate of Occupancy has been issued by the Department of Camm nity Services, Carmel, Indiana.
OFFICE USE ONLY: **************************.~***** ****** ***** *}f~~* ********************
~ FIling Fees: '1.~ 0 I s=Q
SPECTlONS RE UIRED: [ ...,
(.(, ~ase Inspections: /L 77. S-O # Charged Re-
ReViews
Cert. of Occupancy: / i.~ f,' 19
P.R.I.F.: _
4$ 'J..)sll.cO'O
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Reviewed/Approved: Dept. of Community Services
S:Permits!Forms!ILP RESIDENTIAL
(Date)
lo'~-Ol"
Date
Additional Fees