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HomeMy WebLinkAbout07080139 Application`. City of CbrmdlClay Township Permit it:D-7 ?3 RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION ,reiwnr,; For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures BUILDER : S' PH E: (g Ax ? ;? `?sscl? ??? I ne (? x -?5t;77 OF RECORD: STREET ADDRESS: cr?G S?ATE: Alz, el ZIP 1 5f BUILDER'S EMAIL ADDRESS: BEST METHOD OF CONTACT: /) CDA ? ?kvo > . PROPERTY NAME: PHONE: FAX: 6 V -e OWNER: Mlle QS 0, 2 - STREET ADDRESS: CITY: STATE: ZIP: LOCATION LOT le: SUBDIVISION, NAME: SECTION: J? /776 G?5'% 'T4S Gh ? C 1a ZONING: & PROJECT " INFO: ADDRESS OF CONSTRUCTION' t 13SR a „ / Sa • E??Gr/??V © SQUARE FOOTAGE: IO I L SEWER UTILMY PROVIDER: C- -f . t L gl>C?RUIfSj[t41^ej'Y"- !n.. PROVIDER: 4?i1 -• yfit ESTIMATED COST OF CON ON: (EXCLUDING LAND VALUE)?? rbOO 7 - V ? I CAVATION y. ,r, dfr re.. A' -? S'^rIjW DOCItt'?,. S r'Y (- NAME?OF UULITY EX.CONTRAC.TOR' `F1I95I ON tl[ NUMBERS; TAC DATE(S ry ); AND/OR COUNTY W M" 4®R . E AREA DESIGNATION(S) sir }I _L (si?. FLOOD , ?tRV/C TAX MAP P AR I L. I THIS FOR r TYPE F CONSTRUCTION: SINGLE FAMILY O TOWN HOME O TWO FAMILY # of units being constructed at this time: O RESIDENTIAL (For Additions. Remodels. Etc.) PROJECT INFORMATION: Early Release Permit: _Y _N Lot Split: _Y A TYPE OF IMPROVEMENT:^ c NEW STRUCTURE O ROOM ADDITION(S) O PORCH ADDITION(S) O DECKADDITIONCS) O REMODEL _ Basement Finish only O ACCESSORY BUILDING O DETACHED GARAGE ! ATTACHED GARAGE L) DEMOLITION PLUIftift CONTRA hfiin:muu 1 V (uur U 's C- -W 1 Or\ IN u K N 6 Plumber's Indiana Stat 19x ??? lC7WOlR Which plumbing codes will be applied to the construction: O International Residential Code w/Indiana Amendments O Uniform Plumbing Code w/ Indiana Amendments (Check all that apply for the new Manufactured construct Trusses: /Y /N ? Sump Pump: 7Y _N ? l/ ? For Single Family and Two Family dwellings, additions, remodel days of the date of issuance of the building permit, and must be structure permits are subject to the General Administrative Ault of the State of Indiana completing cons I, the undersigned, agree that any construction, reconstruction, erlargemeru requested by this applicatior. will comply with, and conform to, allapplieabb 239) and amendments, adopted under authority of LC. M-7 et sec, General A kitchen, bath, and Door d are connected to the sanitary sewer I further Qaeno?has been i ed b e oartment of Community Services, C Authorized Agent 'D POST & BASEMENT :cures, this p3rkit is valid only if construction commences within 180 of Occu y issutd) within 18 months of the issuance date. Class 1 (Se !AC 12) regarding expiration time frames for beginning and :.. or alcen[ion of a strucrare, or an}' cFange in th a use e: land or structures of -he State of Indiana, and the "Zoning Ordinance of Cannel Indiana -199r (Z- )yof tie State of Indiana, and all Acts arnendatcc- thereto, I further certify that only y that the construction will not be used or occupied until a Certificate of ,Indiana- I { ,?t1 i-Sc„A_7 &SeA ` oat 1 0 1 Irz. OFFICE USE ONLY: :sss::»<:.e*:s*stxx:.::xx.ssa.*sxxasa:xxs::::*?.:.++ : .. s.?j*s.sss:::s:sxs::::s Filing Fees: INSPECTIONS REQUIRED: Base Inspections: Q * Charged Re- 61 Footin ower Footin Under Slab {/0 ? V Reviews Cert. of Occupancy: ough In Meter Ba a Final Site P.R.LF.- Addibonal Fees T L: l ?7Ds ? 6 ReviewedJApproved: Dept of Community Services (Date) S:Penntts/ra?rs/1LP RESIDENTLtt Fee Rreived W: Date