HomeMy WebLinkAbout07030097 Application
City of Cannell Clay Township Permit #: 070 3o~ 7
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, 8< Two Family: New Structures, Additions, Remodels, 8< Accessory Structures
BUILDER
OF
RECORD:
PHONE:
575JCf50 XJCh
\ i5CJAORN:' tvlEP-I I .~ -SA ' S~O CAQM .tTE:
BUILDER'S iMA1l ADDRESS: "'\
. OA~N6'0HE:PHE:.eJJ Q PULlS.e.ovt
FAX;
~-75)?q50
ZIP:
tJ fo ()3 '2__
BEST METHOD OF CONTACT:
PROPERTY
OWNER:
eo
PHONE:
.~ 1(:;;
REi...~ASED FOR ?th an r6gulations ZIP:
i,", ,t ~ comp\lanCA~ W\ ,_,. _,~ .
LOCATION LOT #1: SU,DIVI)i/ON NAME:..- _ _.,. o! St&\e 8n.5Eruq~;r:';;';R\ \~@;. ':Q 1-
8< PROJECT Q LON KlrxtC::STI-\Tt t= -Or::COM",1:l1[\::"'::~.,,-(.,.,cD-
INFO: A2i3l.5WT1>>16'eJ C6 ~ eL \J D CITY OF ~ARlt;~D\A~~i~\' ,~ ~gg~~E: 52i)~
SEWER UTIlITY WATER UTIl.l}r A C"-;::;; "-E5STIMATED COST OF CONSTRUCTION- ,..,/
PROVIDER: 12E6 . PROVIDER: Ll-\i2-M -;n ~ 'i(~~UDING LAND VALUE) $ I g 2 J g
NAME OF UTIUTY EXCAVATION CONTRACTOR; PLAN COMMIS5JON1:Bl>\/~~ ('. _ C7(/)30a:'f
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR s'fW\ ~'Ji.'S.(If'APPLlCABLE): 0 uFfj2--t Ot2.. t; Xc..
FLOOD ZONE AREA DESIGNATION(S) I' II \\~ MAP PARCEL #: . q rv"\ 0 0 c ~7
FOR THIS PROPERTY: ~ - I - ~ - l - :.J .
TYPE OF CONSTRUCTION: TYPE OF IMP TRACTOR:
~SINGLE FAMILY r;z{ NEWSTR~ 'N 1-- \ I/J
o TOWN HOME 0 ROOM AD Plumber's Indiana State License #:
o TWO FAMILY 0 PORCH AD fl I) I 000 I
# of units being 0 DECK ADD L.r () I ()
constructed at this 0 REMODEL
time: Basement Finish r
o RESIDENTIAL (For 0 ACCESSORY BUILDIN
Additions. Remodels. Etc.) 0 DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION
FAX:
-s
STREET ADDRESS:
-,yhich.plumbing codes will be applied to the construction:
~ntemational Residential Code w/Indiana Amendments
J Uniform Plumbing Code wI Indiana Amendments
Lot Split:
_Y~N
Sump Pump:
/Y_N
/Y_N
FOUNDATION TYPE: (Check all that apply for the new
construction area) R,UL UN r: IN [.$l-/eCl
o CRAWLSPACE 0 POST & BEAM PIER
o SLAB ~EMENT(WALKOUT:_Y vN')
Early Release
Permit:
PROJECT INFORMATION:
/'
_Y_N
Manufactured
Trusses:
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 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 Carmel Indiana -1993" (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, bath, and floor drains are connected to the sanitary sewer. I further certify that the construction will not be used or occupied until a Certificate of
Occupancy has been is~ued by the Department of Conununity Services, Cannel, Indiana.
~6 S I1EPrl ffi:)
Print
.;3jQ /07
Date
OF'FI USE ONLY: * * * ** * * * * ** * * * * * * * * * * *** * * * * * ** * * **** * * ** ** * * ****** * *~* * * *** * ** ** * * * * * ** * * ** * * *
INSPECTI UIRED: Filing Fees: ~ 3 0
. . Base Inspections: fl" '7? :5'0
Upper Foot,ng Lower Foot,n Under SlabS. 5 ()
Cert. of Occupancy: _ .3./
P.R.I.F.: / () (, I. !J 0
~' d/ ~ t'70
~-~ .OTAL:. J )ff c7J I ./
U4C~~~~_~
Fee Received by:
# Charged Re.
Reviews
Site
Additional Fees
:Y/~/
Revi
(Date)
Date