HomeMy WebLinkAbout07060084 Application
.'
,-
City of Cannel/Clay Township Permit #:tL/.IJJ;fXB!:f
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
"(
;
I
BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
&. PROJECT
INFO:
SEWER lJT1UTY
PROVIDER:
SUBDIVISION NAME:
j,c~b Or<J>..uc:.
WATER lfTIUTY
PROVIDER:
PHONE:
-.3/7- S7'i - 22~~
FAX:
~7T~225B
CITY:
r=:: . H b"2. S.
STATE:
----.
ZIP:
4(.,03
BEST METHOD OF CONTACT:
-cr?~OA..1J5
PHONE:
J 0/7- ?33-S2:
FAX:
STATE:
.$J.
ZIP:
4kD?
ZONING:
v
SECTION:
-3
V. "e.
SQUARE
FOOTAGE: Ire
ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE) II 3;>cc> ~
NAME OF UTIliTY EXCAVATION CONTRACTOR; PLAN COMMISSION I BZA I BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'5 (IF APPLICABLE):
FLOOD ZONE AREA DESIGNATIDN(S)
FOR THIS PROPERTY:
"
~OJECT INFORMAiWN)
Early Release /' Manufactured
Permit: Y V N ~ Trusses:
Lot Split: Y .,;;:; 1~ump Pump:
Iv_N
-y~
Mjq
TAX MAP PARCEL #:
I '7~cR-Jl- Do-03 - OI5".O()D
PLUMBING CONTRACTOR:
IV! It-
Plumber's Indiana State License #:
Which plumbing codes will be applied to the construction:
o International Residential Code wI Indiana Amendments
o Uniform Plumbing Code w/lndiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area)
o CRAWLSPACE )l!LPOST & _ BEAM XPIER
o SLAB 0 BASEMENT (WALKOUT:_ Y _N )
For Single Family and Two Family dwellings, additions, remodels. and/or accessory stTtlctures, this permit is valid only if construction conunences within ISO
days of the date of issuance of the building permit, and must be completed (Certificate of Occupancy issued) within 18 months he issuance date. Class I
structure permits are subject to the General Administrative Rules of the State of Indiana (See 675 I ~m . frames for beginning and
completing cons
I. the undersigned, agree that any construction, reconstruction, enlargement, relocatio a e he use of land or structures
requested by this application will comply with, and conform to, all applicable laws of the e d a, an the ~Zoning Ordinance of Carmel Indiana - 1993M (Z-
289) and amendments, adopted under authority of I.c. 36-7 et seq, General Assembly of the State of Indiana, and all Acts amendatory thereto. I further certify that only
kitchen, b ,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
occ. cy h been issued by the Department of Community Servi~el. Indiana.
. ~ c::c -p, €.-.- I' "" ~<oOiC...S 048/D7
Signature of Owner or Authorized Agent Print ~
*************************************************
ng Fees: / ';-0 .\0
t;
/ 7:) :;-0 # Charged Re-
I Reviews
Cert. of Occupancy: ") )- S-o
OFFICE USE ONLY: *************
INSPECTIONS REQUI
QiPper Footin~ Lower Footing
~ Meter Base Final
c
J
Reviewed/ Ap oved: Dept. of Community Services
S:PermitsjFormsjtLP RESIDENTIAL
Site
P.R.I.F.:
-07
(Dale)
TOTAL:
Additional Fees
,$f'i'?SC
Date
Fee Received by: