HomeMy WebLinkAbout07050083 Application
City of Cannell Clay Township Permit #1)17 05tJIJf J
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER
OF
RECORD:
NAME: YR.fIz /It; 1:3/2 /e Iff
STREETADDRESS:JICjIO roresf Ln.
PHONE: ;'17 Y'T~e'761
FAX 311-?#)-r-- ~ 0(.
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STATE:
/A/
ZIP foO 3.s
PROPERTY
OWNER:
BUILDER'S EMAIL ADDRESS: . . - I A--L
V / !, /111V.' - 0.. (t'It.,
NAME: y~ .eeJltf',. 13lt; e if'.e PHONE:
BEST METHOD OF CONTACT: 3/7 -- </-90. 6 /'6/
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LOCATION
&. PROJECT
INFO:
LOT #: if 2
SUBDIVISION NAME:
. ,..,....".....,;
CITY: r;r ,~;\L5:l:ATE;~_, L ~_;t.;::) :~X}l~~;:
DEPT ("};~; '<.~;'~:.\/ir,i;; :f',~l.:\/ c r.:!,,)'. ltr~f_-,::
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Fo1es:1 L..;.. /",1)L/7 ~, ./ SQUARE,).. rf. (. :5~
7' - ,r/ L-t'IA /",er /~ FOOTAGE:'
STREET ADDRESS:
ADDRESS OF CONSTRUCTION: /1 r; /0
SEWER UTILm 0:;; If /1.te"-t?' WATER UTIUT.Y,---A~.'" . <\ ESTIMATED COST OF CONSTRUCTION:@/6'c.J 0 <~ <".
PROVIDER: PR~VIDEI3 rt ~~,..~y, - \\, (EXCLUDING LAND VALUE) --11'; ..
NAME OF UTILm EXCAVATION CONTRACTOR; PLAN gOM'IlSfI9~zA.'[B~DOCKIT-> \ \ \~ 'i('l)ebi Ie ,
NUMBERS; TAC DATE(S); AND/OR COUNlY WELL AN?(?R~~E~RERMrp#'S (IF APPUCABLE1;'\ \ \ .
)ROOO1ZO~E';'RE&DESIGNA ONeS) V \\\) i \ i G ?SlGl \\J I TAX MAP PARCEL #:
~13 P"ReP€Rn: f\ \ \ r\\ \ ~'{ ,"D
TYPE OF CONSTRUCTION: TYPE d~JM~ROV~NT:--------PLU~"~ CONTRACTOR: A. J.
0' SINGLE FAMILY tzf N~ ST~UcTURE _____~ ~ t--I l ~
o TOWN HOME 0 ROOM ADDIT!QJ'I(S) Plumber's Indiana State License #:
o TWO FAMILY 0 PO~rrION(S) f.J
# of units being 0 OECK ADDITION(S) r I., C .. / () 3 S' l-/ /
constructed at this 0 REMODEL
time: _ Basement Finish only
o RESIDENTIAL (For 0 ACCESSORY BUILDING
Additions. Remodels. Etc.) 0 DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION
PROJECT INFORMATION: / FOUNDATION TYPE: (Check all that apply for the new
Early Release ~ Manufactured construction area)
Permit: Y N Trusses: _Y _N ~ 0 CRAWLSPACE 0 POST & BEAM _PIER
Lot Split: Y ~sump Pump: _Y ~ ~SLAB 0 BASEMENT (WALKOUT'_Y_N)
Which plumbing codes will be applied to the construction:
~ International Residential Code w/Indiana Amendments
o Uniform Plumbing Code wI Indiana Amendments
For Single Family and Two Family dwellings, additions, remodels, andJor accessory structures, this permit is valid only if construction commences within 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. Class 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.
I, 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 -1993n(Z-
289) and amendments, adopted under authority of I.e. 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
Occupancy ha d by the Departmenuf Community Services, Cannel, Indiana.
-----< .- Ye~/l'" g,e/~L'e
Signature of 0 ner or Authorized Agent Print
,'- J(;l D0
OJ. ". '/
Date
OFFICE USE ONLY: ***** ********************************* ***** ************ ** * ***********************
INSPECTIONS REQUIRED: Filing Fees: r; OtJ. c; 0
pper Footin Lower Footing Under Slab Base Inspections: c::2 f? '7, j t
Cert. of Occupancy: ,)' .5. J.
# Charged Re-
Reviews
P.R.I.F.:
Site
Rev' edj Approved: 0
S:Permits/FormsjIlP RESIDENTIAL
5-/7-()7
(Date)
TOTAL:
Fee Received by:
Date