HomeMy WebLinkAbout07030234 Application
City of Cannel/Clay Township Permit#: n1o~-f
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
& PROJECT
INFO:
[5 PHONS 7~ J 350 X dJ'b
m El2.i D / ArJCITY: STATE-L
BUILDER'S EMAIl ADDRESS:
S. ..s He:PHEi2JJ
~E
NAME:
~E
STREET tr~9 0 tJ
NAME:
STREET ADDRESS:
SEWER UTILITY C ,^J) ^ A,--:1
PROVIDER: nfC..-/VI(:;..L-
Llh03:L
.-0f11 A-iL,
PHONE:
FAX:
CITY:
STATE:
ZIP:
SECTlO
ZONING: S
1
SQUARE / Inj-I
FOOTAGE: IIw
WATER UTIl1TY r Y\ f) JI J - -"ESTIMATED COST OF CONSTRU 3
PROVIDER: L--t\~ G L:.;;:;."~ (~(EX'ClUDING LAND VALUE) .
..,_. ~ C'..r') .. \ \\
-SUPEQ...fOe. E1 C!., ~76ZO 33
/
'-I. 0
s
/'''\:~\~\
NAME OF UTILITY EXCAVAnON CONTRACTOR; PLAN COMMISSION I BZA I ~P-W.:~~j /y~\ '
NUMBERS; TAC DATE(S); AND/OR COUNlY WELL AND/OR SEPTIC P~.';,ITl.'S~I~~!!;;!.CABLE): I~ ~.
FLOOD ZONE AREA DESIGNATlON(S) ,( \I I f \(:::.~. ,~\&.::::;,/ \\ \J
FOR THIS PROPERTY: A \\ \ \ \
'.'1 \
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 _"-1'r
\'.\i
TYPE OF IMP
c:r-NEWSTR~. .~ ~J}AmfYl<>!- ~o1JS
o ROOM ADornt (5) Plumber's Indiana State License #:
o PORCHAD~ON(S) C P
o DECK ADDIT ONeS . . I () 0 00 liLl
o REMODEL . . Which plumbing codes will be applied to the construction:
_ Basement F."'.-L. "nly
o ACCESSORY B'. ~ntemational Residential Code w/Indiana Amendments
i::i ~~~~~~g~: 0 Uniform Plumbing Code wI Indiana Amendments
o DEMOLITION
Manufactured
Trusses:
Sump Pump:
FOUNDATION TYPE: (Check all that apply for the new
construction area)
vy N
~N
o CRAWLSPACE 0 POST &..--. ~EAM N tlJE}Et)
o SLAB ~ENT (WALKbtW" ~~~'
For Single Family and Two Family dwelIings, additions, remodels, andlor accessory structures, this permit is valid only if construction commences witfun 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. qass 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. !
It 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 LC. 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
Occu an has been issue br the Department 0 Community Services, Carmel, Indiana.
/' \ )J.')/ttJ rJ~ ,'-;),j)!:t07
f e.- Of" Authorized All t Print D~
SEONLY:*******************************************************^*~**********************
INSPECTIONS REQUIRED: Filing Fees: -3-1')_ jO
_ -. Base Inspections: 'l?. ) V # Charged Re-
Upper Footmg Lower Footm9\ Under Slab r 0 ReViews
? :;",_ Cert of Occupancy: S ;;. :;)
~' :;; ~jt~1L;--
ept of Community Services ~~ cr-~
S:Permits/FormsjILP RESIDENTIAL
Fee Received by:
Date