HomeMy WebLinkAbout06100081 Application
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City of Cannell Clay Township Permit ttIJ~ J ofJ 08/
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, &. Two Family: New Structures, Additions, Remodels, &. AcCessory Structures
BUILDER of NAMWooitu.. PHONE FAX 03
RECORD: ~1<{ 'r
STREET DDRESS
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,DER1S EMAIL ADDRESS ~J+,Nef BEST METHOD OF CONTACT:
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PROPERTY NAME tj G....-- PHONE i FAX
OWNER: ~;.: ^ L N L)() 37-./ - r .39 - 'ff'i
CI'} STATE
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SEWER UTILITY 'SU ...;- '1),. ;}"r ~',r~ ':>'Em_MA~D'.-COSTC)f CONSTRUcnON:'___
PROVIDER: ['172 W;p "n',", ei!Jd~ ,.-'"(EXCLU'p[t'G LAND VALUE) /'i r(; g~,?~,=?
NAME OF UTlUTY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZf\.J.Bfi<t ~Ei'-',. 'r':;c"~...J _ u~f':::::;:.~; I?::;; "'-11.----....
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PER~~ (iF APPLICABLE): r ~ r;:, C. IF //. -r-.._-__.~ oj \\/7/'( ;;~-.
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""!l' "'.""'"mo., "" '" ."'"OV,",,,, "W"",". 00"'''0011;' /1, OCr 1 ~b -: ~
[3""SINGLE FAMILY ~W STRUCTURE A~. .J4(~:>Q.v! 2a f!Jj0
o TOWN HOME 0 ROOM ADDITION(S) Plumber's Indiana State '~ense '" #:: . ,
o TWO FAMILY 0 PORCH ADDITION(S) C P '1tO 0 g 0---... /
# of Units: 0 REMODEL 8'7 _ D g
o MULTI-FAM.IL Y 0 ACCESSORY BUILDING whic~mbing codes will be applied to the constr~.
o R~s~6~~~AL (F 0 DETACHED GARAGE 5d"Intemational Residential Code wI Indiana Amendments
. . or 0 ATTACHED GARAGE . . .
Additions, Remodels, Etc.) 0 DEMOLITION 0 Un,fonn Plum bong Code w/Ind,ana Amendments
(Multi-Family Construction Code)
LOCATION
&. PROJECT
INFO:
STREET ADDR75S
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LOT · 5> 'I')" SUBDIV'tlil.E
ADDRESS OF CONSTRumON~a
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PROJECT INFORMATION: /
E I R I ~ Manufactured FOUNDATION TYPE:
ar y e ease construction area)
Permit: Y ~ Trusses: Y N
. ./ 0 CRAWLSPACE
Lot Split: Y - N Sump Pump: Vy =N 0 SLAB
Does any part of the property lie within a special Flood designation area: _Y .A
(Check all that apply for the new
o POST & BEAM
G:V1lASEMENT /
WALKOUT:_Y~N
For Single Family and Two Family dwellings, additions. remodels. and/or accessory structures, this permit is valid only if construction comm~nces
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 1O 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 la\vs of the State of Indiana, and the ~Zoning Ordinance of Carmel
Indiana -1993ft (Z~289) and amendments, adopted under authority of I.e. 36~7 ct seq, Gcneral Assembly of the State of lndiana, and aU Acts amendatory
thereto. I furrher certify that only kitchen, bath, and floor drains are connected to the sanitary scwer. I further certify that the construction will not be
used or occupied until a Certifica e of Occupancy has been Issued by the Department of Community Services, Carmel, Indiana
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OFFICE USE ONLY: * * ******* ************** ***.~**** *** ****** * ****~J'j *'!~*~O****************
FIling Fees: !...if , ~
NSPECTlONS REQUIRED: v/",sase Inspections: ',-,;2 "77 :>0 # Charged Re-
Under Slab 10 j I -Il ReViews
Cert. of Occupancy: .>,"3 ,~/;
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1/ v2 61. &,0
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P.R.i.F.:
Additional Fees