HomeMy WebLinkAbout07040223 Application
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City of Cannell Clay Township Permit #: C) 7 o,tf 07,7.3
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICAtION
For Single Family, Town Home, &. Two Family: New Structures, Additions, Remodels, &. Accessory StrJctures
I
BUILDER
OF
RECORD:
STREET ADDRESS:
STATE:
NAME;
s
FAX;
58(-
qL
Ll 606 J-
BEST METHOD OF CONTACT:
,
____n r'\ T
u
PROPERTY
OWNER:
....J..'...J:.-...., , .~ 'I ",,-,, ..
P~Jbj8Ct to compliance with all f~ulatjons
nf C:'.-,h"l i~' I n;,~1 """",-
STREET ADDRESS;
OUEPT OF COMMU,SJI'T"{ SERVICE!S
\ I
ZON:!:~J..
SQUARE Q, r J
FOOTAGE: 48/I)S
r"1
ncro.'\c"'!1CI frol fo.V-
SEGION:, I. 'A
jj\ii.,..!li-U
LOCATION
&. PROJECT
INFO:
LOT #( 1 0
SEWER UTIlITY
PROVIDER:
ESTIMATED COST OF CONSTRUcnON: 1-1 0
(EXCLUDING LAND VALUE) I
f33
S IJJ.Z,~OIG 6Xt '
TAX MAP PARCEL, #0' 22... 0 .1- 00'
/1- (- -0 -05 - h.
00
NAME OF UTILITY EXCAVATION CONTRAcroR; PLAN COMMISSION I BZA I BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'5 (IF APPLI
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY:
"
"
PROJECT INFORMATION:
Early Release _Y \./""N
Permit:
_Y _'-'f;(
TYPE OF IMPROVEME ~ \ PLUM ING CONTRACTOR:
IV/f[EW STRUCTUR \t) 11\1\ 4- ~ S
o ROOM ADDITIO (S) ~ ber's Intp.ana State License #:
o PORCH ADDrn (S) . 0 I
o DECK ADDrnON S) I . (
o REMODEL t F' 01 Which plumbing codes will be applied to the construction:
_ Basemen inion y
o ACCESSORY BUILDI G QY(,;temational Residential Code w{Indiana Amendments
o DETACHED GARAGE .. .
o ATTACHED GARAGE 0 Umform Plumbing Code w/Ind,ana Amendments
o DEMOUTION
'OUNDATION TYPE: (Check all that apply for the new
;onstruction area)
TYPE OF CONSTRUCTION:
e>YSiNGLE FAMILY
o TOWN HDME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions. Remodels. Etc.)
o CRAWLSPACE 0 fOPr(jnm~-r-+-t~
o SLAB cr-BASEMEt:l:ttvvAL~0rl':l-Y~
. .... on. n ,_ ~ ,--_' \ \
F S. 1 F '1 dT F ., d 11' dd dl dI h":----' L__ r~dJ~T~..!1 \VI lC>....\i \11 -bin
or mg e anu yan wo amt y we mgs, a itions, remo e s, an or accessory structures, t, ~s,~~~~ v~ ......~y~~!!~E~u.CtlOnl wmR-fnces WIt . 180
days of the date of issuance of the building pennit, and must be completed (Certificate of Occup'~cy ~-'t8ued)w1tliin 18 months of theiiSfu~ce date. Class I
structure pennits are subject to the General AdministraO.'ve Rules of the State of Indiana (See 675. IAc,:; 12) regarding expiration time &Jfues fj'\- beginning and
completing construction. \ \ r. \ \ 7 ~nrq \ \ I I \ .
I, the undersigned, agree that any construction, reconstructIOn, enlargement, relocation, or alteration of aft~q~;ture, ~ cJb.nge irHh"t use of\l~hqlor\structury=s
requested by this application will comply with, and conform to, all applicable laws of the State of Indian~~ anH\t~e "Zoning ord.inance of Canne\1kdi~na - 1993"I(Zr
289) and amendments, adopted ul1der authority of LC. 36~7 et seq, General Assembly of the State of Indi!nt lrid all Acts amendatory.t-hereto.-J' urther ~ertify that only
kitchen, bath, and floor drams are connected to the samtary sewer I further certify that the constructum will~e used or occupied until a Certificate of
Occupancy has been ISS ed y the Depjtmcnt ofjCommuruty SeIVlces, Cannel, Indiana \ __ ---l
,/ J'U.,uJ '-.WA-rJrJt=. S'tfFPH~ '-i,/dL:;/o1
signatur Print Date
,
Manufactured
Trusses:
Lot Split:
Sump Pump:
~y/ ~
0:::;;0::-
_Y_N
P,R.I.F.:
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SEONLY:************************************************************
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Filing Fees:
INSPECTIONS REQUIRED:
~wer Fo~nder Slab
Base Inspections:
Cert, of Occupancy:
# Charged Re-
Reviews