HomeMy WebLinkAbout06060151 Application
Ob060IS/
City ofCarme//Clay Township Permit #:
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, &. Two Family:
BUILDER of
RECORD:
NAMEDr
PROPERTY
OWNER:
FAX
STATE
LV
ZIP
4wo33
ZONING:
6~
LOCATION
&. PROJECT
INFO:
WATER UTIIJTY
PROVIDER:
SQUARE
FOOTAGE:
6~107
SEWER UTIIJTY
PROVIDER: I
ESTIMATED COST OF CON5lJlUCTJON:
(EXCLUDING LAND VALUE) ff
NAME OF UTIIJTY EXCAVATION CONTRACTO ; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNlY WELL AND/OR SEPTIC PERMIT #'S (IF APPllCABLE): .
TY;;YF CONSTRUcnON:
SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units:
o MULTI-FAMILY
# of Units:
o RESIDENTIAL (For
Additions, Remodels, Etc.)
I
PLUMBING CONTRACTOR:
tAlLI f.. ~midJ
Plumber's Indian Sta~ License #:
rr\ [~({~ I S~'~ n \\ :~~-;.~.;-.r::;V
~='::1~~:;;~::=~J!~.:~i~Q'~~.i'~Jt
o Unifonn Plumb/'ll! ~~e W7lHdiaila().~eJ' tS r
(Multl-Famlly CortstluGll!'.n Code) ; IJiit,
,. ?
Manufactured FOUNDATION PE: (Check all that apply for the' w
/: /'. construction area) !
Y V N Trusses: -"'-- Y _N
/' ./ 0 CRAWLSPACE 0 .JlOST & BEAM
Lot Split: Y V N Sump Pump: ~Y _N 0 SLAB [d" BASEMENT . ~
Does any part of the property lie within a special Flood designation area: _Y...6 WALKOUT:_Y---'<:::::....N
TY~F IMPROVEMENT:
NEW STRUCTURE
o ROOM ADDmON(S)
o PORCH ADDmON(S)
o REMODEL
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLmON
PROJECT INFORMATION:
Early Release
Permit:
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 pennit, and must be completed (Certificate of Occupancy issued) within 18 months of the
issuance date. Class I structure pennits 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
sttuctures 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 -1993" (Z~289) and amendments, adopted under authority of I.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 funher cenify that the construction will not be
used or occupied ~ntil a Certificate of Occ,!pancy has heen issued by the Depanment of Community Services, Cannel, Indiana.
'.13 - Lol/.; A. B:Rl>SoAY,-fJE"'/;NE (.,1t9/~
Signature of Owner or Autho Print Date .
OFFICE USE ONLY: ********** * *** *** **** ******* ****** *** *** * *** ***~ *****~**** *** *** *******
Filing Fees: W C- LP
INSPECTIONS REQUIRED: ,C,7~7 ""0 # Ch d R
Basec~TION sz. --' J arge e-
~rFooting-"""~rFootin~nPl!!l~SED FUI-i' , ,~ "0 Reviews
.. . . '--~ vU '" 0 corn~rt;,<o1i.obolllpEOOlY!atlons ..) .::>. J ,
-CROUGh In ~ Final, ite 0 State i3rW,L-8~al Codes. /.;z (, /. 00 Additlonal Fees
iF COI\/;~tJNITY SERVICES -
ITY OF CAR~~ CLAY T~A~!P $; sa 1- '7 cJ
Reviewed/Approved: De t. of Community Services (Date) N N 'tl
S:Permlts/FonnS/lLP RESIDE L