HomeMy WebLinkAbout06040089 Application
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City of Carmel/Clay Township Permit #: oee 01(!)()<6'1
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER of NAME
RECORD:
PROPERTY
OWNER:
LOCATION
& PROJECT
INFO:
LOT #/;{
FAX
58J- cFIS
STATE
YN
.r . N';-/-
BEST METHOD OF CONTACT:
U;& J~
PHONE FAX
CITY
STATE
ZIP
SECTION I
ZONINGS _
ADDRESS OF CONSTRUCTION
)7
C/O'
SQUARE
FOOTAGE 5790
'I (X)O
SEWER UTILITY
PROVIDER:
ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE) c;;;}
NAME OF UTILITY EXCAVAll N CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WEll AND/OR SEPTIC PERMIT #'S (IF APPLICABLE):
(7/.c.R~;jf-
PROJECT INFORMATION:
Early Release',,' ", Manufactured FOUNDA lION TYPE: (Check all that apply for the new
, V construction area)
Permit: _Y _N Trusses: ~Y_N
, Y 0 CRAWLSPACE
Lot Split: '. .'--,---YLN Sump Pump: ...L::::...Y _N 0 SLAB
Does aP08t~~If'-UR~~eNFlood designation area: _Y...LLN
For S~gll?itln;lil\D.u\;PtW>>Wimft lM\!niii\!k~i~dels, and/or accessory st
within ISO dayoff StcL-datoodi>~@1UaIoObd\!aBlding permit, and must be complete
issuanco\!P-r:~.'C'efMMtJN1"I"Y ~1,,~~cral.AdminiS[fativc Rules
.~: '.' _... - ~~ IHh<&h1- begmmng and completm
I. theGl~i~; ~RMJiif.,:JnGI.A1I6. if~lfilargement. relocation. or
structures requested by this ~AN~ comply with, and confo~~m~' \
Indiana - 1993~ (Z~ 289) and a~~fuents, adopted undC~. . . 'n
thereto. I further certify that only kitchen, bath, and flo d _ a
use OCCUPi~d mil a Certificat of Occupancy has i e y the Depar~~cf'9f
, 0~
Sig ture of Print
*** *********************************~~*****'*****************
Filing Fees: 7-.6 P, h. r7
INSPECTIONS REQUIRED: .-J <'7 -7 .- cJ # Charged Re'
Base Inspections: ~ L /. J
Upper Footing , - Reviews
Cert. of Occupancy: 33. S' 0
P,R.I.F,: ! c2. ;hI. ;) 0 Additional Fees
\-4Id~T?L7J~:iO &.0 ~. ~4
Fee~ed bv ~ ~ ~ ~?f;
TYPE OF CONSTRUCTION:
~ SINGLE FAMILY
tJ TOWN HOME
o TWO FAMILY
# of units:
o MULTl-FAMIL Y
# of Units:
o RESIDENTIAL (For
Additions, Remodels, Etc.)
TYPE OF IMPROVEMENT:
M NEW STRUCTURE
D ROOM ADDITION(S)
o PORCH ADDITION(S)
o REMODEL
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION
PLUMBING CONTRACTOR: ()
~ /} /Y/ech..m/ca
PlumbeA Indiana State License #:
t2 A 10(0 LfSL/O
Which plumbing codes will be applied to the construction:
~ International Residential Code wI Indiana Amendments
o Uniform Plumbing Code wI Indiana Amendments
(Multi,Family Construction Code)
o
~
POST & BEAM
BASEMENT
WALKOUT:_ y-X-N
'1-5-010
Date
I
Reviewed/Ap oved: Dept. of Community Services (Date)
S:Permit5fForms/ILP RESIDENTIAL