HomeMy WebLinkAbout07030104 Application
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MAR 1 5 2007 i! Iii
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IXI ROOM ADDITION(S) ~~umber'sIndlana State License #:
o PORCH ADDITION(S ~~;(I.o.L i 0 ( -, 77
o DECKADDITION(S) llJ"'o - {
o REMOBDEL t F' 'h ~w ich plumbing codes will be applied to the construction:
_ asemen InIS on V
o ACCESSORY BUILDINA MI' International Residential Code wI Indiana Amendments
g ~~~~~~~ ::~fiE 12 '~U Uniform Plumbing Code wI Indiana Amendments
o DEMOLITION
PROJECT INFORMATION: FOUNDATION TYPE: (Check all that apply for the new
Early Release ^ Manufactured construction area)
Permit: _y L/N Trusses: _Y ~NY 0 CRAWLSPACE 0 POST& BEAM_PIER
Lot Split: _Y ~mpPump: _Y~ \ ~r;t'SLAB
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this pennit is valid only i_CO . ~ within ISO
days of the date of issuance of the building permit, and must be completed (Certificate of Occupancy issued) with~ i anee date. Class I
structure permits are subject to the General Administrative Rules of the State of Indiana (See 675 IAC 12)~e S . e ames for beginning and
completing construction. '.@l
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alteration of ange 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,. . e oning 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, ba ;~nd floor draim are connecred to rhe sanitary,",wer.-Ifurther certify that the construction will not be used or occupied until a Certificate of
Occup,," d beeni"UedbYtheDepartm?Of~mmUnityse~~\;:'~I'InE-~a ~ rJv-- TIl-_ 3/'('( 07
Slgnatu I) Owner or Authorized Agent I . Print \ ' Date
OFFIC E ONLY: ************~******* ***7**** *************************~,**f **~~******************
\ 1 C V F'I' F I J/, J (I
INSPECTIONS REQUIRED: ) , I mg ees: , ( ,
. . \ Base Inspections: 1// () I.) # Charged Re'
Upper Footing Lower Footing lIer Slab ./;> /(j ReViews
~,. . --., --<-.,._~ Cert, of Occupancy: ..::::oJ ~
Rough In Meter Base Site \
! Additional Fees
\
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BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
& PROJECT
INFO:
SEWER LmLITY
PROVIDER:
City of Cannel/Clay Township permit#:0103010i
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
V?- ~rJ STilA-< C-TlD.J
STREET ADDRESS: ~ r:?
I ::sq b 7 J/''':'''# 1'-1).
PHONE;
-DJe..- S7D-lv:?0
~\S'l-
STATE:
ZIP:
<f{, 01" L-
FAX:
~-yo -( 721
BUILDER'S EMAIL ADDRESS:
BEST METHOD OF CONTACT:
1', '1 -c; 4'1. .r-
PHONE: t:.t I f - ~t
~t'l-
ZIP:
<fbojJ
rtL ffD '-, L--:J~
FAX:
~~HX-
Of/--Je'
NAM,i: J
fvt I c.~
STREET ADDRES:: J
r-I ", lA./ C51VJoOf)
LOT #: + SUBDIVISION NAME:
3 Woo;>~t:lL-
ADDRESS OF CONSTRYCTION: ";"\
S7f.,. r WcrTWoa>> vM.K'
STATE'
~
SECTION:
ZONING;..-,
:::. ~ I
Cal
-'5:1. .~~~ 0 --
iff@
SQUARE
FOOTAGE: tfOo
ESTlMATED 'COST-OF:CONsTRurn
(EXCLUDING LANO:VALUE) ,~, , '
il:
;;Z,< I
M;;~\!
NAME OF LmLITY EXCAVATION CONTRACTO ; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC OATE(S); AND/OR COUN1Y WELL AND/OR SEPTIC PERMIT #'S (IF APPUCABLE):
FLOOO ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY:
TYPE OF CONSTRUCTION:
'fi!l SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
Dil RESIDENTIAL (For
Additions. Remodels. Etc.)
Zo",~ )(
('
-""'l;
Dept. of Community Services (Date)
S:Permits!forms!ILP RESIDENTIAL
Date
Fee Received by: