HomeMy WebLinkAbout06110083 Application
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City of Cannell Clay Township Permit #: (')& II GO:?')
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
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BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
& PROJECT
INFO:
SEWER UllLI1Y
PROVIDER:
NAME: ,
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STREET ADDRESS:
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LOT #:
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SUBDMSION NAME:
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PHONE:
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CITY'
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FAX:
ADDRESS OF CONSTRUCTION:
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WATER UTILITY
PROVIDER:
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STATE:
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ZIP:
PHONE:
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FAX:
ZIP:
SECTION:
ZONING:
R2~..G}:,.Sii:;~~ F~d:::~
ESrrr-tATEb" OOSfOF'OONsTRlitTION:':
(EXCLUDING LAtm:VALUE)::~1! lJ:-CJ;c ~O
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TAX MAP PARCEl/II: ; . ,-:.,' .:'~ ? >....
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PLUMBING CONTRACTOR: 1 ..",,-,,~" 1;,< '.
j \ _ .... '--.. 6' '.11 i :
~~'" OWkw......... <'0110 ////i'
Plumber's Indiana State-Uc:.ense #.:..... iXI III
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Which plumbing codes will be applied to the.construction:
o Intemational Residential Code w/In~na~""ndments
o Uniform Plumbing Code wI Indiana Amendments
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NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE):
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY:
TYPE OF CONSTRUCTION:
-dl.. SINGLE FAMILY
[] - TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
~ RESIDENTIAL (For
Additions, Remodels. Etc.)
PROJECT INFORMATION:
Early Release
Permit:
Lot Split:
_YAN
_y1N
TYPE OF IMPROVEMENT:
o NEW STRUCTURE
~OOM ADDmON(S)
o PORCH ADDmON(S)
o DECK ADDITION(S)
o REMODEL
_ Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
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o DEMOUTION
Manufactured
Trusses:
Sump Pump:
_YAN
LY_N
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FOUNDATION TYPE: (Check all that apply for the new
construction area)
o CRAWLSPACE 0 POST & _ BEAM PIER
o SLAB tsI. BASEMENT (WALKOLIT:_y-LN)
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 permit, 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 IAC 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, all applicable laws of the State of Indiana, and the "Zoning Ordinance of Carmel Indiana -1993ft (Z-
289) and amendments, adopted under authority of r.c. 36-7 et seq, General Assembly of the State of Indiana, and all Acts amendatory thereto. I further certify that only
kitchen, bat ,and floor drams are connected to "Sarlltary sewer Tfnf'~r certify that the constructIOn Wlll not be used or OCCUpied until a CertifIcate of
Decu n ."ued by the Dep ent of Commuruty semchannel, Ind.",.
/ W M~ M.~l?1vj 10 I "J "Zre'
o orA thorizedAgent ~nnt ~
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EQUIREO' I ,(YV 5{., d Filing Fees: 1-;1 7- .)
. ~ . (A/~I.P'('
) d- b Base Inspections: d ~- Q CJ
er a . .........-:
Cert. of Occupancy: 53 . ~ 0
S;Permits/FormsfILP RESIDENTIAL
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