HomeMy WebLinkAbout07040084 Application
City of Cannell Clay Township Permit #: 07 Cffoo~
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, 8< Two Family: New Structures, Additions, Remodels, 8< Accessory Structures
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DDCKET
NUMBERS; TAC DATE(S); AND/OR COU"'::-!,!E~~DiOR SEPTIC PERMIT #'5 (IF APPUCABLE): ,J
FLOOD ZONE AREA DESIGNATION{s(fJ' '&0 \:
FOR THIS PROPERTY: ~ "~"\ '\
/" 1"'-- \'--"-= \
TYPE ,OF CONSTRUcTION: P PROVEMENT:
/ r._...... \C~.../ 1'\(\
(if SINGLE>FAMIL Y \ 'l.\)v RUCTURE
o TOWN'HO!4,E O~~O OOM ApDITION(S)
o TWO FAMILY ~ PORC DDmON(S)
# of Unil:S'being 0 ADDmON(S)
. '\'
constructed at this REMODEL
time: ~ ,\ \)V"~ _ Basement Finish only
o RESIDENTIAL (For 0 ACCESSORY BUILDING
Additions:Remo.del ,Etc.) 0 DETACHED GARAGE
~ 0 ATTACHED GARAGE
o DEMOLmON
FOUNDATION TYPE: (Check all th~ply for the new
construction area) 0"\'1, !0~
n.\')' ,~\o
o CRAWLSPAJi"\~~~~~- ~ _PIER
o SLAB ~~&~~~ &'-.LN)
ai -'" v~
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this Or is . . ~';r( t' ences within 180
days of the date of i"uance of the building permit. and mu" be completed (Certificate of o~':.~~ ~. inJ~~~(\ issuance date. dass I
structure permits are subject to the General Administrative Rules of the State of Indiana ~~~~ ~~ain8:~~~e frames for beginniIig and
completingcomtructi~~ ~\eC Q\ ~ rO"" \. \ ~~\,\>:-
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alterSM:n of a st~~<':'b ~~m~e.use of land or structures
requested by this application will comply with, and conform to, all applicable laws of the State of India lM~" 1 g ce of Carmel Indiana -1993n (Z~
289) and amendments, adopted under authority of LC. 36~7 et seq, General Assembly of the State ofl~~~ p\tfa cts am datory thereto. I further certify that only
kitchen, bath, and floor drains are connected to the sanitary sewer. I further certify that the const~'kI not be used or occupied until a Certificateo!
Occupancy has ~en issued by the Department of Conununity Services, Carmel, Indiana. c,\
BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
8< PROJECT
INFO:
SEWER UTILITY
PROVIDER:CI
NAME:
s
bf\',vE S
SUBDIVISION NAME:
PROJECT INFORMATION:
Early Release
Permit:
Manufactured
Trusses:
6_N
LY_N
Lot Split:
C
Reviewed/ Ap
_Y --4
_YLN
Sump Pump:
PHONE:
(3
FAX:
STATE:
IN
ZIP:
PHONE:
FAX:
g
CITY:
I~
STATE:
I
J <i
ZIP:
s
SECTION:
,3
ZONING:
s-
SQUARE
FOOTAGE:
ESTIMATED COST OF CONSTjiUcnON:
(EXCLUDING lAND VALUE) ~ Ii'
TAX MAP PARCEL #:
PLUMBING CONTRACTOR:
1BW E. SM" nl
Plumber's Indiana State License #:
10/777
Whi~IUmbing codes will be applied to the construction:
C0' International Residential Code w/Indiana Amendments
o Unifonn Plumbing Code wi Indiana Amendments
'-//'D/01
LoR; 14. B;fn~<:;Or-\G- J-Iu,J:tJf
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