HomeMy WebLinkAbout07030087 Application
City of Cannel/Clay Township Permit #: 0103 CXJ87
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, 8r. Two Family: New Structures, Additions, Remodels, 8r. Accessory Structures
BUILDER
OF
RECORD:
PROPERTY
OWNER:
NAME:
STREET ADDRESS:
LOCATION
8r. PROJECT
INFO:
LOT #:
SEWER UTILITY
PROVIOER:
fL1f2u)
D
WATER UTIUTY
PROVIDER:
PHONE: 4/5 - 045'1
F^4/5
PHONE:
FAX:
CITY:
STATE:
ZIP:
ZONING:
SQUARE '1.,/ /\ J
FOOTAGE: J{l..Lt::::1(
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'5 (IF APPLICABLE):
~ T fYlDtJl{l
For Single Family and Two Family dwellings, additions, remodels. and/or accesso ~~. rt i~ n'I~onstruction commences within ISO
days of the date of issuance of the building pennit, and must be completed (Cer e..~tl ~'t4tt}.wif~\f8 ~onths of the issuance date. Class I
structure pennits are subject to the General Adntinistrative Rules of the State of In~tSee t51 ~ ~~ i:~h~~tion time frames for beginning and
completing construction. ~ 0 ~'\-l\'V~~\r--
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or '!J.t.'~lob_cta~cture~any change in the use of land or structures
requested by this application will comply with, and conform to, all applicable laws of the Stalv'o ~, and the ~Zoning Ordinance of Carmel Indiana - 1993" (Z~
289) and amendments, adopted under authority of LC 36~7 et seq, General Assembly of the Sf&~ Indiana, and all Acts amendatory thereto. I further certify that only
kitchen, bath, and floor drains are conn ted to the sanitary sewer. I further certify that theYonstruction will not be used or occupied until a Certificate of
Occupancy h been issued by the D t e of Community Services, C~I I@iana.
FlOOO ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY:
TYPE OF CONSTRUCTION:
kvsINGLE FAMILY
6 TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions, Remodels. Etc.)
PROJECT INFORMATION:
-y~
_yLN
Early Release
Permit:
Lot Split:
TYPE OF IMPROVEMENT:
~EW 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 DEMOLITION
Manufactured
Trusses:
Sump Pump:
.,{N
-y~
\
OFFICE USE ONt : ***************************************************:*
Filing Fees:
Base Inspections:
Cert. of Occupancy:
Print
ECTIONS REQUIRED:
S:Permits/Forms/ILP RESIDENTIAL
Final Site
P.R.I.F.:
Fee eceived by:
ESTIMATED COST OF CONSTRUcnOr.j:
(EXCLUDING LANO VALUE) /
TAX MAP PARCEL #:
(CVjJ
I bd1!l
Date
*******************
.,
# Charged Re-
Reviews
Additional Fees
(j
Date