HomeMy WebLinkAbout06060214 Application
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City of Cannell Clay Townshjp~.r Permit #:~
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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PROPERTY
OWNER:
PHONE
FAX
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STREET ADDRESS
CIlY
STATE
ZIP
LOCATION
&. PROJECT
INFO:
LOT # SUBDIVISION NAMENl _
Z-C-- . QI1 q-
ADDRESS OF CONSTRUCTION
2- 5 NoeD ILt ftv~
SECTION
ZONING:
'Pup
SQUARE
FOOTAGE: 2l tJ q
SEWER UTILITY WATER UTILITY ESTIMATED COST OF CONSTRUCTION:
PROVIDER: C-", ?-MSL PROVIDER: C-f'c (2. ME: L-- (EXCLUDING LAND VALUE) 120 0 () 0
NAME OF UTIllTY EXCAVATION CONTRACTOR; PLAN COMMISSIDN j BZA j BPW DOCKET LV I LL S <OIN{f-
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEmc PERMIT #'5 (IF APPLICABLE):
TYPE OF CONSTRUCTION:
o SINGLE FAMILY
ftst- TOWN HOM E
't}- TWO FAMILY
# of units:
o MULTI-FAMILY
# of Units:
o RESIDENTIAL (For
Additions, Remodels, Etc.)
TYPE OF IMPROVEMENT: PLUMBING CONTRACTOR:
~NEWSTRUCTURE -:PAUL t:: SM/IH
o ROOM ADDlTlON(S) Plumber's Indiana State License #:
o PORi!DDlTlON(S) 0- P 8/ 0 l -=t---:t11
o REMO ~ h' hi' '11 be 1- h .
o Ace ~}ftI~ W Ie p umbmg codes WI app led to t e construction:
o DETACH D9f,~r Of:? PEL International Residential Code wI Indiana Amendments
o ~~~df!:/)II'!lIc:J:f&kir..rm Plumbing Code wI Indiana Amendments
o 'i1'P'S% Co iill{j ( l<'II~)ji!~"~nstrUCllon Code)
PROJECT INFORMATION: r- C 111~ oC'!j re-:v rr;~
Early Release M f ct d '~Ai\1.si (;i\lfQ6fCDt.~bN,. PE: (Check all that apply for the new
anu a ure '- /e COi\s6\tttI~area)
Permit: _Y LN Trusses: ~Y ~IA 0JIL';::<:CfT E 0
',.,AI A U (SSM POST & BEAM
Lot Split: _Y LN Sump Pump: _ Y ~N . ""l ~ s(I(61S 0 BASEMENT
Does any part of the property lie within a special Flood designation area: _ 'ft;~ N WALKOUT:_ Y_N
For Single Family and Two Family dwellings. additions, remodels, and/or ac~essory structures, this permit is valid o~ly if construction commences
within 180 days of the date of issuance of the building permit, and mll' .Ef.~~~Alts,.s~ed) within 18 months of the
issuance date. Class I structur> permits are sub~ec( to the General,Ad, pjJJ:. ' . ' t ' ~b~f~KV5IAC 12) regarding expiration
time frames for bcgmnm tBd lIS I~
I, the undersigned, agree that 'construction, reconstruction, enlargement, relocation, or alteration of a structure, or any change in the use of land or
structures by this a 'cation will comply with, and conform to, all applicable laws of the State of Indiana, and the ~Zoning Ordinance of Carmel
India 199r ~289) and endments, adopted under authority of I.c. 36~7 cr scq, General Assembly ofrhe State of Indiana, and all Acts amendatory
t eto, I fuft r certify tha nl itchen, bath, and floor drains are connected to the sanitary sewer. I further certify that the construction will t be
sed 0 DC ied untih G rt 'lcau: of Occupancy has been issued by the Department of Community Services, Carmel, Indiana,
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Print
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Oate
Base Inspections:
Cert. of Occupancy:
# Charged Re-
Reviews
P.R.I.F.:
Additional Fees
Reviewed/Approved: Dept. of Community Services (Date)
S:Permits/FormS/ILP RESIDENTIAL
Fee Received b ,