HomeMy WebLinkAbout07070082 Application
City of Cannell Clay Township Permit #: tJ707f'XJ8~
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
&. PROJECT
INFO:
'~5\JC"~~-'-
STREET ADDRESS:
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NAME'
S.\ ~ e.,;~o....1A.Q.
STREET ADDRESS:
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LOT #:
SEWER UTILITY C>--r-\"-) ~
PROVIDER: , \ \"-~ Y
SUBDIVISION NAME:
Cc-.r
~~
PHONE:
CITY:
STATE:
ZIP:
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BEST METHOD OF CONTACT:
.C
PHONE:
CITY:
~
ESTIMATED COST OF CONSTRUCTION:~, __
(EXCLUDING LAND VALUE) ~0.':::::> \ E:l:z:l::::,
NAME OF lfTILTTY EXCAVATION CONTRACTOR; PLAN COMMISSION I BZA I BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUN1Y WELL AND/OR SEPTIC PERMIT #'S (IF APPUCABLE):
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY:
TYPE OF CONSTRUCTION:
~INGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions. Remodels. Etc.)
Early Release
Permit:
PROJECT INFORMATION:
_V v:
_VLN
Lot Split:
TYPE OF IMPROVEMENT:
~EW STRUCTURE
o ROOM ADDITION(S)
o PORCH ADDITION(S)
o DECK ADDITION(S)
o REMODEL
_ Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
o AlTACHED GARAGE
o DEMOUTION
Manufactured
Trusses:
Sump Pump:
LV_N
LV_N
~
TAX MAP PARCE~ it:
1/'
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ill I
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----.
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PLUMBING CONTRACTOR:
I
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uu
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Plumber's Indiana"State-License_ #:
~\()lD41;; 110------
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Which plumbing codes will be applied to the construction:
~ntemational Residential Code w IIndiana Amendments
o Uniform Plumbing Code wI Indiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area)
o CRAWLSPACE 0 POST & BEAM PIER
o SLAB O"'6ASEMENT (WALKOlfT:_V-0 )
For Single Family and Two Family dwellings, additions, remodels. and/or accessory structures, this permit is valid only if construction commences within 180
days of the date of issuance of the building pennit, and must be completed (Certificate of Occupancy issued) within 18 months of the issuance date. Class I
structure pennits are subject to the General Administrative Rules of the State of Indiana (See 675 IAC 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 hmd 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 - 1993~ (Z~
289) and amendments, adopted under authority of r.c. 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
Occu cyhas issue the Department of Community Services, Cannel, Indiana.
< )~""'^ :2e,ikA I ~ -.J ,3'<::;)
pnnt ~ Date
OFFICE USE ONLY: ****** ********************** * **_~***** *~***********7tJ *3**** **~*****************
INSPECTIO ReQUIRED: Filing Fees, / . t.; ,;:0
, . ,> Base Inspections: ,;:2 /J 7. ') 0
~er Foot.n Lower Footing Under Slab 0
c ,~ V' '. Cert of Occupancy: ,>),5
cMeter Base/<..... Final Site / 1 I
~, - P,R,LF,: ,.,I- (;. () (j Additional Fees
$dh/? S-O
# Charged Re-
Reviews
TOTAL:
Fee Received by:
Date