HomeMy WebLinkAbout07010073 Application
BUILDER
OF
RECORD:
PROPERTY
OWNE'R:
LOCATION
&. PROJECT
INFO:
SEWER UTILITY
PROVIDER:
City of Cannel/Clay Township Permit #:fJ16 I 0013
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
'SQUARE
FOOTAGE:
ESTIMATED cosr OF CONSTRUCTION:
, (EXCLUDING LAND VALUE)
NAME OF UTIlITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA I BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPT1C PERMIT #'S (IF APPUCABLE):
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY:
TYPE OF CONSTRUCTION: TYPE OF IMPROVEME
o SINGLE FAMILIiELEASED FOg G, QR..~
o TOWN HOME Subject to cornpli't:jc!k()' ii11f1 iWfItm~~s
o TWO FAMILY of State a,1Il LI!ORti'l<Alwl." !ON(S)
# of units ~l!Jb:r OF COM~~~m~QI1I(llIS
constructecHHhi!i
time: CITY OF CARME ; _ ~ilV~~IY
o RESIDENTIAL (For I "JP, I ~SSORY BUILDING
Additions. Remodels. Etc.) 'L:l 'OITACHED GARAGE
ATTACHED GARAGE
"fill DEMOUTION ~
PROJECT INFORMATION: r- ~ FOUNDATION TYPE: (Check all that apply for the new
" ___ a ' " constru~on area)
Early Release L/:.-'
Permit: _Y _N /Trusses: _Y ~)<1 l;I1AWL5PACE-------O POST & _ BEAM _PIER
Lot Split: _Y _4' Sump Pump: _Y _N 0 SLAB 0 BASEMENT (WAlKOUT:_Y_N )
For Single Family and Two Family dwellings, additions, remodels. and/or accessory structures, this pennit is valid only if construction co~ences 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 pennits 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, all applicable laws of the State of Indiana, and the ~Zoning Ordinance of Cannel Indiana - 1993" (Z-
289) and amendments, adopted under authority of l.c. 36'7 et se eral Assembly of the State of Indiana, and all Acts amendatory thereto. I further certify that only
kitchen, ba , d or s are connected to the san' sewer. I furthe tify that the construction wiI! not be used or occupied until a Cera/kate of
Occup 'Y h be n i ed by the Department of ommunity Services, I, Jndi a.
I~b ? 'r.;
2.Q
Ii
PLUMBING CONTRACTOR:
: JAN'
1 0 2007
Plumber's Indiana State License #:
,./)
, .
.J ...--
Which plumbing codes will. be applied to the constructi~!!.:.,._.
o International Residential COde w IIndiana Amendments
o Uniform Plumbing Code w/lndiana Amendments
t)/\
J -{()-07
Date
Signatu
OFFICEUSEONLY:******************************~~***************************~()******************
INSPECTIONS REQUIRED: FIling Fees: .1:33 ' -5
Base Inspections: _1""6, 50
Cert of Occupancy:
Upper Footing
Rough In
Lower Footing Under Slab
Meter Base FinalSJ
# Charged Re-
Reviews
Additional Fees
P,R.I.F.:
Date
Reviewed/ proved: Dept. of Com'munity Servi es
S:Permits/FormS/ILP RESIDENTIAL
Fee Received by:
/,