HomeMy WebLinkAbout06080191 Application
"
City of Cannel/Clay Township uJ J1 ~ Permit #:0 h O'f?~ I~J
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICA:TION
For Single Family, Town Home, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
&. PROJECT
INFO:
NAME:
I
NAME:
PI;
STREET ADDRESS:
13~
FAX:
Sl.\.;TE ~OO
CITY:
I", .
STATE:
I
ZIP:
BEST METHOD OF CONTACT:
0'-
FAX:
CITY:
:r
STATE:
:I
ZIP:
"~D
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY:
LOT#:
30
SUBDIVISION NAME:
B
SECTION:
ZONING:
TYPE OF CONSTRUCTION:
o SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
/ time:
~ RESIDENTIAL (For
Additions. Remodels. Etc.)
Early Release
Permit:
PROJECT INFORMATION:
_Y LtV'
_Y1N
SQUARE
FOOTAGE: Jl./5~
SEWER UTIUTY WATER UTILITY
PROVIOERCJ PROVIDER: C
NAME OF UTI EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE):
ESTIMATED COST OF CONSllUCTION:
(EXCLUDING LAND VALUE) II'
Lot Split:
Jb
Co
.
TI
TAX MAP PARCEL #:
Manufactured
Trusses:
Sump Pump:
--&N
1Y_N
For Single Family and Two Family dwellings, additions, rernod55SS0ry structures, this permit is valid only if construction commences within 180
days of the date of issuance of the building permit, and must be . i~e~ "ficate of Occupancy issued) within 18 months of the issuance date. c;lass I
structure pennits are subject to the General Administrative ~les 0 ~Co ~~See 675 lAC 12) regarding expiration time frames for beginning and
r!1I.!"P0~' ~dU;'C~
I, the undersigned, agree that any construction, reconsrruct.QJ a em.~, ' n, '6itW:fR ~ructure, or any change in the use of land or structures
requested by this application will comply with, and conform to, i:0-,..~ t~..Y _8'f ~~Ijqn , ~"ZOning Ordinance of Carmel Indiana - 1993" (Z'
289) and amendments, adopted under authority of I.c. 36'7 et seq, Genefale5~~~ na~:r. a amendatory thereto. I further certify that only
kitchen, bath, and floor drains are connected to the sanitary sewer, I further c '~-;~1\9~~ ~l- ~d or occupied until a Certificate of
Occu~ancyhas be~n issued by the Departme~t of Conununity Services, Carm ,i!i4iJ'lb ' I Y 8. Ss. IOI)~
. '8/30/t'k
OfFICE USE ONLY: **************** **i1*~~***
INSPECTIONS REQUIRE : V fl
Upper Footing Lower Footing Un
~~~ Meter Base (final S~
tJJL. #JJI
Reviewed/Approved:' Depl. of Community Services (Date)
S:Permits/FormS/IlP RESIDENTIAL
D...
Ba
********V~****************************
/"33 · 50 1()7.Df);.4..-D
~ tj,; tJO ...rh, J'B r. (ee.
--5 0 1I.e"le.., ~
. /1 DiJl1.0o ~
o;...~
~"
Q)
Cert. of Occupancy:
P.R.I.F.:
Date
Fee Received by: