HomeMy WebLinkAbout07050264 Application
.~. d. City of Cannel/Clay Township Permit #:0705 O~
~ RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
'''.. .' For Single Family, Multi-Family, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER of
RECORD:
PROPERTY
OWNER:
STREET ADDRESS
LOCATION
&. PROJECT
INFO:
LOT# .207
CIA.
SUBDIVISION NAME
SEWER LfT1LITY C
PROVIDER: . 'I il vJ f)
WATER UTIUTY G
PROVIDER:
C_ I<
NAME OF LfTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA I BPW DOCKET
NUMBERS; TAC DATl'(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPUCABLE):
TYPE OF CONSTRUCTION:
ey/SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units:
o MULTI-FAMILY
# of Units:
o RESIDENTIAL (For
Additions, Remodels, Etc.)
TYPE OF IMPROVEMENT:
D/"NEW STRUCTURE
o ROOM ADDITION(S)
o PORCH ADDITION(S)
o REMODEL
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITlON
PROJECT INFORMATION:
Early Release
Permit:
FAX
STATE
,..-.,
ZIP
ytz
BEST METHOD OF CONTACT:
~
0/
PHONE
FAX
CITY \ STATE ZIP
1~ r.=~fi='n- .[j~lr-'\\!
LS ~S'sECnoN~ 3 L:= \ zrITNG
01 ~~~~E:O'1
r
.1'0
JQO.'~
PLUMBING CO NT CTOR:
,~u" ( tfQ"~~
Plumber's Indiana State Li ense #:
/0 )-';cJ if
- ,
Which plumbing codes will be applied to the construction:
~mational Residential Code wI Indiana Amendments
o Uniform Plumbing Code w/Indiana Amendments
(Multi-Family Construction Code)
FOUNDATION TYPE: (Check all that apply for the new
construction area)
Manufactured /
_ Y _N Trusses: Y N
- ~ 0 CRAWLSPACE
Lot Split: _ Y _N Sump Pump: ~Y _N CJl.-SlAB
Does any part of the property lie within a special Flood designation area: _ Y _N
o EPST & BEAM
G:""'BASEMENT .
,.. .i'WAlKOlfT:_Y ..--/'N
',." . r .~ ~.k: , 1
For Single Family and Two Family dwellings, additions, remodels, and/or accessory stAIPllrS;S.rhi~~m' 'f-f~&:'Ij;''''f';' .:'_ '(ft'QN>m~ences
within 180 days of the date of issuance of the building permit, and must he complete~~h:Ifb c !c~nfiX<ls ". , T~, .~. \itlOl"lits of the
issuance date. Class I structure permits acc subject to the General Administrative Rule~lSt:tQ (}mlR ~ ~?e~ .' _ .;.- egarding expiration
time frames for beginning and completing construoic8.tate and uoq.~, ,,~...L- .
I, the undersigned. agree that any construction, reconstruction, enlargement. relocation, or aJ.t..epR'1R ~t~~M ~~a\lJCRSd Of
structures requested by this application \vill comply with, and conform to, all applicable law~E=t&: ~tMlofl1lcrra'ri.a. jln tAA ~~liijii~ri~'~mcl
Indiana -199r (Z~289) and amendments, adopted under authority of LC. 36-7 et scq, Gen'Ol:p(etlfr ~AAM:~1 dtdt,..!,'\hd !lIt'AHs' amendatn:ry
thereto. I further certify that only kitchen, bath, and floor drains arc connected to the sanitary sewer. I further cqtN~t~NA- construction wHl not be
used or occupied until a C ni{jca.te of Occupa.ncy has been issued by Hepartmcn~ of com:unity Services. Carmel, Indiana. _ ._
Z l.( t- ?b (/- ) -?.J -u7
519 ture of Owner or Authorize Agent Pri~t Date
***************************************~**************************
Filing Fees: / (J ~:? / ()
.2N~CTlONS REQUIRED: ' '7 <9Z _)"'(/
~ Base Inspections: ~ CL~ _
6pper Footi k6Wer Fnotiflg Under Slab
~ Cert. of Occupancy: ,<)s: :nJ
~~~I P.R.I.F.: /?-6/ dO
If:;:; bill / (j
~
# Charged Re-
Reviews
Additional Fees
TOTAL:
~~
I {(;>-I-01
Reviewed/App ved: Dept. of Community Services (Date)
S:Permits{FormsjIlP RESIDENTIAL