HomeMy WebLinkAbout06100201 Application
.I
BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
&. PROJECT
INFO:
City ofCarmeUOay Township Permit #:() 0/ (J7) ;)177
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
'W5-7211
FAX:
STATE:
t,:)
'-f DZ:L
BUILDER'S EMAIL AllI(RESS:
L-. \)c;IN8Se)T~"lN-D(\1.~. CDWl
NAMES,DN, Gue:rdULvH
srRiYr7T' Soe.lJ1g ~ Dt1.
f!E<;r MtL OF CONTAcr:
PHONE:
<i4Lf-5D5'f
CITY:
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FAX:
STATE: ZIP:
(/.J 4&03 L
mO~Ti
LOT #7
SECT!
SQUARE
FOOTAGE:
WATER lITILITY /7.,lj) ^. r:7
PROVIDER: L/'{l::A ,,6 L-
ESTIMATED,cosfoF CONSTRUcnON:
(EX77~?i__N/~;u\~!?~~~LUE) 2 S- cIJ()
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NAME OF llTIlfTY EXCAVATION CONTRACTOR; PL6.N COMMISSION / BZA I BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUmY WELL AND/OR SEPTIC PERMIT #'S (IF APPUCABLE):
.... " :TAX MAP;f~AAC~ #:
r." '. tr () '"'
TYPE OF IMPROVEMENT: PLUMBING~ONTRAC!~R~l . '.
o NEW STRUCTURE ' . " . Ki:'j~-.. /,:'
o ROOM ADDITION(S) Plumber's Indiana state License'#:-,
o PORCH ADDmON(S) \ -.".
~CK ADD~N(S) l 'TwJJ " .
REMODEL ket(\h~ lit Which plumbing codes will be applied'tithe construction:
_ Basement FiniS on y
o ACCESSORY BUILDING 0 International Residential Code w/Indiana Amendments
o DETACHED GARAGE ,. .
o ATTACHED GARAGE 0 ~~~~~~~I~.mblng Code w/lndlana Amendments
o DEMOLmON " .... . .
. ,}c:.4' ,',: ,fOU~DATION'JYPE::.(C;:heck aJtthat apply for the new
Manufactured (L"7<'j"c~ \"~ "! ~: ~o~~~~ur~~n ~.r~a~
Trusses: _Y c~;;t''';._ "'::'. O..CAA\'ILS.~~E 0 POST& BEAM_PIER
Sump Pump: -\7=~'>':;[., O.SlAB EJ- BASEMM(WALKOUT:_Y_N)
~,' - .' 0- " ,., ~'i ~~,,_ ".,"
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY:
rJ/A-
SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions, Remodels. Etc.)
PROJECT INFORMATI01!: /
Early Release / ..
Permit: y ~N/
Lot Split: _ Y ----6
'_.".,'..~.: .......,....,.....,.':.',.,._', ",...~ l....'"~"-',.~'.,," ,.,..~
For Single Family and Two Family dwellings, additions, remodels, andi&'accessory ~thictures~.thls perii'iit: 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 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.
I, 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, aU applicable laws of the State of Indiana, and the ~Zoning Ordinance of Canne11ncliana - 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, ,and floor drains are connected to the sanitary sewer. I further ertify that the construction will not be used or occupied until a Certificate of;
Occup ~partmentofconunUnitysmjm. armel.Indiana. ~N.ES. /'0 kD I~
Signature of Owner or Authorized Agent Print Date
OFFICEUSEONLY:****************************************************:5:3***************************
(2; F'!' F . L ,,()
INSPECTIONS REQUIRED: \ I Ing ees. , '--
. . II \lJ Base Inspections: / / 7 # 6 ()
Upper Footing Lower Footmg Under Slab ;( , ~7 0- 0
e ~ V Cert. of Occupancy: 0-0 '
ough In Meter Base Final Site ,m _
~ //;(.-01, .'V.R.I.F.:
Revie WApproved: Dept. of Community Services (Date)
# Charged Re.
ReVIews
Additional Fees
S:Permlts/Forms/ILP RESIDENTIAL