HomeMy WebLinkAbout07010116 Application
BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
&. PROJECT
INFO:
SEWER UTILITY
PROVIDER:
City ofCarme/lClay Township Permit #: 0/'D1011 1/1
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
FAX:
~3'5;2 Cfo
%~o3
~.~.~ "~ t < , _'P' '"' . ~,;':_~:'!~:s'rRU(;lff'if\,< (
C '" -"" t",'J<~i(""v" ",.r-", ...... .'-'; \I
() l ,",( t~l_ .. ." - , i f.\H !'h:C1Hr,-,;,n,-"r"
[""H."~" " --'- "1--, "......! ["" :
PONE: .rcPT 0.... -'> ')~ FAX: 11 -.orl~ ~
<;;t'-\C>_C~'''''' ','-.IIift1ii;'","", c'r:;;" ,
o -.JA~'O~W~'lV"~',~, 7< , '} ..&~1>1\d~:~'J..:
,~, -, ~1;t1I ~ ; i :'J rl. ',J ........,,-:
51ATE:, ,..~_,.lt j; ZIp.:)l/1;-'i\i'Sj~'-1U;)
:iff.Q)"I\j,j v 3'3
ZONING: R-2...1
cm'
(2a,(Y\-t...l
SECTION:
SQUARE} ~
FOOTAGE: 0( 00
ESTIMATED COST of CONSTRUCTION:
(EXCLUDING lAND VALUE)
bOO
NAME OF UTIlITY EXCAVATION CONTRACTOR; PLAN COMMISSION I BZA I BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'5 (IF APPLICABLE):
TAX MAP PARCEL,#:
I
I
i
......J
lij
ii!
flOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY;
,;:
JAN
?nm
N:
TYPE OF IMPROVEMENT:
"
PLUMBING CONTRACTOR:
---.13 ~ Q(\ W O~
Plumber's Indiana State license #:
~>{'~ I DOOO SJ,?:'
TYPE OF CONSTRU
SINGLE FAMILY
.,\TOWN HOME
oil .'TWO FAMILY
V\. # of units being
constructed at this
time:
o RESIDENTIAL (For
Additions. Remodels. Etc.l
o NEW STRUCTURE
o ROOM AODITION(S)
o PORCH ADDmON(S)
o DECK DmON(S)
9< ODEL
( _ ment Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLmON
Which plumbing codes will be applied to the construction:
o International Residential Code w/lndiana Amendments
J& Uniform Plumbing Code wI Indiana Amendments
PROJECT INFORMATION:
Early Release ~ Manufactured
Permit: Yy ,N// Trusses:
Lot Split: '-N Sump Pump:
FOUNDATION TYPE: (Check all that apply for the new
~ .__________construction area)
_y ~ 0 CRAWLSPACE 0 POST & BEAM PIER
-y ~N 0 SLAB)if BASEMENT (WALKOUT:_Y+N)
For Single Family and Two Family dwellings, additions, remodels. and/or accessory structures, this pennit 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. dass 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, all applicable laws of the State of Indiana, and the "Zoning Ordinance of Cannel Indiana -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, bath, floor drains are nne 'd to the sanitary sewer. I further certify that the construction will not be used or occupied until a Certificate of
Geeu 'ane); 1",enissue by eOe tmento!Co UnityserviC'"'j;;;;/:'";..! Se.oqqo--J /-/f.{) 1
Signa Print Tr Date
OFFICE USE ONLY: *******************************.~**l!(******************* ~~***~******************
INSPECTIONS REQUIRED: Filing Fees: ...3 {}
/, '(/(j
~:2_ SO
Lower Footing Under Slab
~
Base Inspections:
# Charged Re.
Reviews
Cert, of Occupancy:
Additional Fees