HomeMy WebLinkAbout06040176 Application
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City of Carmel/Clay Township Permit #: f)Gfjt-j ()/7~
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER of
RECORD:
NAME
;/(
PHONE
YI- ;2-"162-
FAX
r~- 'f "Ll.V
PROPERTY
OWNER:
STREET ADDRESS
c) Lr ,/V:
ZIP
J 2-'lQ
BEST METHOD OF CONTAcr: ,.,.--- ~
(.r ':- r /?<q r I
FAX
NAME
STREET ADDRESS
ZIP
(I
SECTION
.('I'~p.~,",
. (zO,NING:' ~
LOCATION
&. PROJECT
INFO:
LOT #
ADDRESS OF CONSTRUCTION
'. ? ),.{( -<'/--" t/~.
SQUARE /? ~
FOOTAGE: L-/ (;I '--
SEWER lJTILITY
PROVIDER:
ai'll.-
WATER UTILITY /
PROVIDER: {, et..A- M A.-
ESTIMATED COST OF CONSTRUcnON/. </2 (1_0
(EXCLUDING LAND VALUE) (. 0 (} (/.
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'5 (IF APPUCABLE): <'/t I'll A.
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT: PLUMBING CONTRACTOR: ~ ~~ A
o SINGLE FAMILY /' r - /' 01' r/'A ~
ii:Y NEW STRUCTURE r:&-',,~ / cr-~ p~4 ~ 'tr tt
~ TOWN HOME 0 ROOM ADDITION(S) Plumber's tndiana State Id'cense #: lfA~A
o TWO FAMILY 0 \1lP' "2
# of units: 0 PORCH ADDITION(S) /0 r ~ a 9 .t..:" ,~
REMODEL (' --"i:; ...-
o MULTI-FAMILY 0 ACCESSORY BUILDING Which plumbing codes will be applied to the construction: '''~
# of Units: ~ /" ..
O 0 DETACHED GARAGE lYInternational Residential Code wI Indiana Amendments
RESIDENTIAL (For 0 ATTACHED GARAGE
Additions, Remodels, Etc.) 0 0 Uniform Plumbing Code wI Indiana Amendments
DEMOLITION (Multi-Family Construction Code)
PROJECT INFORMATION:
Early Release t./'" Manufactured , /"
Permit: _ Y ----..N Trusses: ~ _N
Lot Split: _Y ~N Sump Pump: _y./N ~~:LSPACE
Does any part of the property lie within a special Flood designation area: _y'/ N
FOUNDATION TYPE: (Check all that apply for the new
construction area)
o
o
POST & BEAM
BASEMENT_y . -I
WALKOUT: '-'N
For Single F_- . LY '~bm'~'6mlf~rrt@Nels, and/or accessory structures, this permit,isyalid~only_ifS..Q!1~JJJl~.t~oJ},commences.
within 180 rs ~dat~ Ori~~a I ea1YY~' BWsand must be completed (Certificate of Oc~pp-a~cY~~~l!~d)_'v.:i~h}n:~8'~9n~~(o~~he
issuance ciat . q fRtM~~~~~JfaW ~u ~Cj- t~~eneral Administrative Rules of the State of Indi~.fta\(See~!~~!.~~_:1.2)~-,,~g<lE~}r:g_f;.~i,riatiion
of State and Lacs. rnrelf8'mes for beginning and completing construction. ! ill/I ill' \
It the underSi~p~'W .Ft~~if,'ti~@~iG,6filrgcment, relocation, or alteration of a struc~H.~. ':?f. ~ny change. in the ~se of land OF. !.' i ;:
structures r~~ i;~t~~~mr; to, all applicable laws of the State of Indiana, ana theJj"~m~oro.manamu f Cannel'! i
111 I" lUV, I I if
Indiana -19 2 an ,a e u no I yo I.C. 36-7 et seq, General Assembly of the State ofilndia a, a d Atts amendatory, ) . :
thereto. I further certify that only It-N:~hl\:W$\and floor drains are co~nected to the samtary sewer. I further c~rtify~that the construction will not lie./ :
used r occupied un~il a ~icate of Occupancy has been issued by the Departmen~ of Community Servic~s, Caimd;Indiana:-------.----.: ;
7~ d C 6tocG L-------y~2--7---~-6-J
re of Owner or Authoriz d Age Pri6t Date
OFFICE USE ONLY: *********************************************~***~********************
Filing Fees: 6 7.070
INSPECTIONS REQUIRED: -,;2 7 1 '1('
Base Inspections: " C/
Cert. of Occupancy: S -3 - :5 tl
e~1t. M~~'_
l TOTAL: 1??.]/' Ad
~ .... .ff--ev~.
Fee eceived by: /
# Charged Re-
Reviews
Site
C>rd.,;G\ hl~o^-- S-s-cA..
Reviewed/Appro~ed: Dept of Community Services (Oate)
S:Permits/FormS/ILP RESIDENTIAL