HomeMy WebLinkAbout07050111 Application
City of Cannel/Clay Township Permit #: 07rL'<:O" I
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER
OF
RECORD:
NAME: D \LEES
PROPERTY
OWNER:
:)(l
STREET ADDRESS;
FSl3lf7-7JiK
41Oz1{
PHONE:
FAX:
CITY:
STATE:
ZIP:
LOCATION
& PROJECT
INFO:
LOT #:
1
SEWER UTILITY
PROVIDER:
ADDRESS OF CONSTRU
q'
Ct\rl\LL
NAME OF UTILITY EXCAVATION CONTRAcrOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WElL AND/OR SEPTIC PERMIT #'5 (IF APPUCABLE):
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY:
TYPE OF CONSTRUCTION: TYP .OF IMPROVEMENT:
o /SINGLE FAMILY NEW STRUCTURE
G!f TOWN HOME hi ,.8QQM:~~~@N
o TWO FAMILY RELEASED FOIj \.fl6Rbl DDtl'W~~
# of units bll',I)..!!. \ \0 comoli~Cf!)Elii(l. mo\li(!i)"-
c"onstructecAlt'tlll~ f 5\ \~ aM LIW!'IOl)Bdes.
time: 0 8. ~~6JSh'DnIY
o RESIDENTIAL ~e!'PT OF cOfvlbl\~ESSOR'hIl!.l.um:MP
Additions. ReJ(l.<IllEllWtc.l-ARMl9. ~A6liEib~~ItA'Gf
vii y ur v 'I.Q.,\,~~~HEDGARAGE
PROJECT INFORMATION: 1l:!)J l51!iIKlLITION
Early Release / Manufactured /
Permit: Y N Trusses: Y ~
Lot Split: Y ,~ Sump pump: Y N'
ZONING: P Lt 1)
SQUARE ~' iq 0
FOOTAGE: L-l{) .
LtD
SECTION:
ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE)
JDI-\-
eurJrCttA-\ "
TAX MAP PARCEL #:
PLUMBI~CONTRACT~: .
Clu L L 7?m I T\d-
Plumber's Indiana State License #:
lol,ll
Wh.!9"plumbing codes will be applied to the construction:
0' International Residential Code w/Indiana Amendments
o Uniform Plumbing Code wI Indiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area)
--
o )'RAWLSPACE__Q-~post & Ii ':icBEAM-~PIER
0' SLA8:-r=~YBAs~"E~T:(W~l~gm':::?\\~ \\\ N)
l,. \\ ~~--~ '.1\ \1\
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this permit;i~\,:.ilJ~ only if construct!on~~en~~~\wi~ ISO
days of the da~e of issllar.'-ce of the building pennit~ and ~ust be completed (Certifi~ate of Occupancy issueI4),_~t~in If\.JPP.9th~of $e iM\lance dr~fE~8I~s I
structure pemnts are subject to the General Admuustratlve Rules of the State of IndIana (See 675 lAC 12) regardmg ex~ahbn trme frames for begmnmg and
completing construction. i \ \ \ \ \ ___-' \
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alteration of a structur~, Qr any:c~~gein.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 ":t;oning brdinance of Carmel Ind~a~1993""(Z-
289) and amendments, a~o ted under authority of r.c. 36-7 et seq, General Assembly of the State of Indiana, and a1l4cts amendatoryj;hereto.-HGrther certify that only
kitchen, bath, and floor d i, s are connected to the sanitary sewer. I further certify that the construction will not be.used:oroccupied until a Certificate of
Occup.n<,yhas be,n iss ed by the I?epartrnent of Community sm"ce~arrnel' Indiana, r;~~" ./ I _
I ~ " -eUS,ClL G~I r I + V\. 5 q b)
Signature of Owner or Authoriz Agent Print Date
OFFICEUSEONLY:*********************************************************************************
e.. F'I" F . ~ ~~ CJO
Cll0NS REQUIRED: 5f~ ling ees. . . P
L F t- ~d~SI Base Inspections: , ,t) 0
ower 00 mg lL~e~~ GV
c::-: ~ ~ Cert. of Occupancy: 5,-,) D~_
~eter B~ Fina Site P.R.I.F.: ! A; h-./ , D f)
dt ~;) '7 7 , ()()
7
t. of Community Services
S:Permits/Forms/IL RESIDENTIAL
# Charged Re-
ReViews
Additional Fees
TOTAL:
Fee Received by;
Date