HomeMy WebLinkAbout07040144 Application
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BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
&. PROJECT
INFO:
NAME:
PHONE:
-:LtJ( 311.15)"-7ozg
FAX:
3f7.J.S's:f(66
STREET ADDRESS:
CITY:
1/1;,,, Av". '-'-rl.l,~ j
CL:2:.:{1l-~jj~C~. BEST METHOD OF CONTACT:
Q .l4.jJ C S,iWor C ,.h3.f7 J..S-S '7(/[K
v ~ PHONE: . FAX:
r(flr!.f7r D(Ire 9.....//1 (1)fN'/~7<'5
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NAME:
Ii?o~,~
STREET ADDRESS:
//.::1,S S~
LOT#:
c.:C:rr
{:,""JI'I'
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SUBDIVISION NAME:
~.Jt.6.:;"~,,
ADDRESS OF CONSTRUCTION:
/fOC.t; S.J ._0'- C>
WATER UTILITY
PROVIOER;
SEWER UTILITY
PROVIOER: c..T'R~.D
C~/_..I
~
STATE:
ZIP;
4.210
\ 1..:
C!J/VI
CITY:
e'MI
STATE:
iJ
ZIP:
</~u32.;
ZONING:
SECTION:
"3
I
SQUARE I
FOOTAGE: ~~O
::r/J '-I~032.
ESTIMATED COST OF CONSTRUcnON.07b ;.,.
(EXCLUDING LAND VALUE) 7, 00 000.
, ,
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUN1Y WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE);
APR 1 8 2007
FLDOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY;
TYPE OF CONSTRUcnON:
0- SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
~ RESIDENTIAL (For
Additions. Remodels. Etc.)
PROJECT INFORMATION:
Early Release
Permit:
Lot Split:
_Y_N
_Y~N
TYPE OF IMPROVEMENT:
o NEW STRUCTURE
~ ROOM ADDmON(S)
o PORCH ADDmON(S)
o DECK ADDmON(S)
o REMODEL
_ Basement Finish onlv
o ACCESSORY BUILDING
o DETACH EO GARAGE
o ATTACHED GARAGE
o DEMOLmON
Manufactured
Trusses:
Sump Pump:
_Y_N
~Y_N
0..;>0
,
~
.',' I
~n"' tc.."l-~8
Which plumbing codes will be applied to the construction:
o International Residential Code wjlndiana Amendments
~nifonn Plumbing Code wjIndiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area) 6edrc:or<'l ~i ''/
gj CRAWLSPACE 0 POST & B _PIER
o N)
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this permit is valid only if 0 ences within 180
days of the date of issuance of the building permit, and must be completed (Certificate of Occupancy issued) within oo.t \ssuance date. C,lass I
structure permits are subject to the General Administrative Rules of the State of Indiana (See 675 lAC 12) regar e frames for beginning and
completing construction. ~ I
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alteration of a st nange in the use of land or structures
requested by this application will comply with, and confonn to, all applicable Jaws of the State of Indiana, an ~., Z- mg Ordinance of Cannel Indiana - 1993" (Z'
289) and amendments, adopted under authority of LC. 36'7 et seq, General Assembly of the State of Indiana, an.. I 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 0/1
Occ cy has be~~ by the Department of Community Services, Cannel. Indiana.
~ A L 4ha\()'1
Print
D.le
*********************************************%J*~******************
F'I' F . SJ'(. /0
INSPECTIONS REQUIRED: ling ees. . ,
--=- - Base Inspections' - J P ~ ,.-/~ # Charge, d Re-
<:!fpper Foot'l1!f Under Sla '. cy () ..&.~ Reviews
-- - Cert. of Occupancy: Sl: ~{J ,
Site
Additional Fees
"7
,~ -c..
ReviewedjAppr ved: Dept. of Community Services (Date)
S:Permlts/FormS/ILP RESIDENTIAL
/,o;z 70
Fee Received by:
Date
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