HomeMy WebLinkAbout07010079 Application
City of Cannel/Clay Township Permit#: tJ 7(J!Oo17
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICA;rION
For Single Family, Town Home, 8< Two Family: New Structures, Additions, Remodels, 8< Accessory StrJctures
BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
8< PROJECT
INFO:
SEWER lJTILITY
PROVIDER: CJ\ f-
NA~fFRt~ HOMf,c
ME~jt 11'1
STREET ADDRES~:l
qr}Oa N.
PHONE:
n YY395i
S-t: ?lCD /:.J
BUILDER'S EMAIL ADDRESS:
+ t"Y\ ~.J-- r\H @
NAME:
I
t-bm
ERJ Df tW 0h:"3 \j.)
SUBDIVISION NAME:
R..
j"ZrJ,JYONT'f{()'tA V I 5TA
WATER UTILITY
PROVIDER: C..F\e. M EL
STREET ADDRESS:
q;;lO';) M
LOT #;
'3~
\7L
bl<.lVE
FAX:
317 !if f' 707
lS
STATE:
I^'-l
ZIP:
l,:l (" 0
BEST METHOD OF CONTACf:
dI7HO,?:tj~. qs IY
FAX:
0(7 s:'1 r 707
cm:
:L'Ilbpl :s
STATE-
:.L rJ. '
ZIP:
L[k,J.(,O
SECTION:
ZONING:
ROSO 1//
SQUARE ,// '7 ~
FOOTAGE: 'two(....;./
ooJ)'s
NAME OF lJTILITY EXCAVATION CONTRACTOR; PIJ\N COMMISSION I BZA I BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPllCABLE):
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY:
TYPE OF CONSTRUCTION:
~ SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions. Remodels. Etc.)
PROJECT INFORMATION:
Early Release
Permit:
Lot Split:
_y /N
YVN
TYPE OF IMPROVEMENT:
Jl<( NEW STRUCTURE
o ROOM ADDITION(S)
o PORCH ADDITION(S)
o DECK ADDITION(S)
o REMODEL
_ Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLlTIDN
Manufactured
Trusses: 4v _N
Sump Pump: ~Y N
'Ei:~Pri/4TIO,J
:Ii
TAX MAP PARCEL #:
, ,
flr"11
;.! 11! 1 fl
I)nr)7
v
'I
v
PLUMBING CONTRACTOR:
EARL G~\ffSOrJE--
Plumber's Indiana State License #:
'-~---_.~--....~-_...
j
.J
I
l
f 0 59 Dq
.
Which plumbing codes will be applied to the construction: I
o International Residential Code w/Indiana Amendments
~ Uniform Plumbing Code wI Indiana Amendments I
FOUNDATION TYPE: (Check all that apply for the new
construction area) i
o CRAWLSPACE 0 POST & BEAM ~PIER
. I
o ( A KOUT: "''1\ '.'N
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this pSOOjB&~6 ~ij~t~~.~'- ~fO
days of the date of issuance of the building permit, and must be completed (Certificate of Occupancy iSSU~d) .,l5tiittp~eb~r!;j8~'. t~::'C.T ,as a.S~s I,
structure permits are subject to the General Administrative Rules of the State of Indiana (See 675 IACJll '9i ~\'f~i.~tIme"11-~r:por ~g~i~ and
completing construction. U~ '1- I..iUIYI IVI UNITY SERvICt:S
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alteration of ~~F'lfTY6.Iaw~th, ystIOfil~~f~IP
requested by this application will comply with, and conform to, all applicable laws of the State of Indiana;"and the ~oni~'dldtJJ&'hl(~hdiW..Y~!)~""
289) and amendments, adopted under authority of LC. 36-7 et seq, General Assembly of the State of Indiana, and all Acts amenda~NAfurther certify that only'
kitchen, bath, and floor drains are connected to the sanitary sewer. I further certify that the construction will not be used or occupied until a CertiBca.te of!
OcCUPjcy has been i,;sued by the Dep"'tment of Community Servic~el, Indiana, '
~~-<i! -f)EfJZEL!-&fS IIA MEi<!..f!..rrr /~I/{)1...
Signature of Owner or Authorized Agent Print Date
OFFICE USE ONLY: *************************************************************":*******************
INSPECTIONS REQUIRED: Filing Fees: g> ,r- I ;! 0
'. '. Base Inspections: c2'1? ,J rJ # Charged Re.
Upper Foot, g ower Foot'" Under Slab _ /() Reviews
Cert. of Occupancy: , -) 3. .J '
fIIiiiIS;te -; I 0
~ P.R.I.F.: /,) 6(. 0
I e-r -Z - ~ -0'1 "c:2
oved: Dept of Community Services (Date)
S:Permits!FormS/lLP RESIDENTIAL
Additional Fees