HomeMy WebLinkAbout06040182 Application
Cfty of Carmel/Clay Township c.\.M-permit #: tJ f.etJ4tJ(r>~
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER of
RECORD:
NAME
p-
PHON~r ,
2'1(L
FAX
y{- Y'7-ZY
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ad
ZIP
2l{O
STREET ADDRES
BUILDER'S EMAIL ADDRESS
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PROPERTY
OWNER:
NAME
STREET ADDRESS 9::
LOCATION
&. PROJECT
INFO:
2;;-') 2.
LOT #
ooG
o (,{ 1/1.e... ief....,
SEWER LITIlITY /'
PROVIDER: C--tA,( 1'\ ~
ESTIMATED COST OF CQNSTRUcnON:
(EXCLUDING LAND VALUE) YZ dO 4, ~
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION I BZA / BPW DOCKET /
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE): /'t ~ ~ Ii / ',;/1
TYPE OF CONSTRUCTION: TY~ IMPROVEMENT: PLUMBING CONTRACTOR: .It. ' It
o SINGLE FAMILY ,-- /' 0... ,+- .0,
~ ~~~ ~(~~ .~
lfi!/6 ~~~:I~; 0 ROOM ADDITION(S) Plumber's Indiana Sta License #: t'4@' ~~' '1~
o PORCH ADDITION(S) / 9 't .0
# of units: 0)' 0 ~' ~
o REMODEL - ...,.
o MULTI -FAMILY 0 ACCESSORY BUILDING Which plumbing codes will be applied to the construction: , ~
# of Units: - ~ .,~_
O 0 DETACHED GARAGE ~Intemational Residential Code w/lndiana Amendmen"(V
RESIDENTIAL (For 0 ATIACHED GARAGE
Additions, Remodels, Etc.) 0 DEMOLITION 0 Uniform PlumbingCodew/lndianaAmendments
(Muiti-Family Construction Code)
PROJECT INFORMATION:
FOUNDATION TYPE: (Check all that apply for the new
construction area)
,./ Manufactured /
_ Y ~N Trusses: Y N
/. "7 0 CRAWLSPACE
Lot Split: _ Y -'L...N Sump Pump: Y _N Q--$LAB
Does any part of the property lie within a special Flood designation area: _ Y i./"'N
Early Release
Permit:
o
o
POST & BEAM
BASEMENT ~
WALKOLfT:_ Y-=:::::::"N
For Single Family and ~E.~lfiD~;N~~~T~~ccessory structures, thi~peEmiti"p}}c!~o~lfifWn~\,;;~tioh ;C,Omll)enCeS
within ISO days of thegloM1gbf~1Q<lBf:frA~~\l&t?HB m' 9'lffh"'f1~~ e completed (Certificate,9fq~c~p~)n~y:}~ssl.,l~g) witli~~~~hsi ?fthe
issuance date. Class I structure perrgt i'{(t"So.~-!f~t to<<r.~eEer:a~ft.M.lms rative Ru~cs of the Stat~ ?lIIrid~aiiii-(See675-IACI2) regardi"j1'~ e~ptration
o a e a(1~q ~FbYiB@gmnmg and completmg construCtlOn'l) j \ \ \ \ 1! \
It the undersigned, agree ID!iItnT c@.fir€G}W~~~n9~~tG)ftSloca(ion, or alteration of a ~~~u4~~e, or lmnchang4n ,~m'e of t~d Pf'!
structures requested bY~II'I~~~il(R lY\M~~, :w4c~OOlO~umicable laws of the State df: Indiana, an{tihr "ihning{)fdinance of Gannel
Indiana - 1993" (Z- 289)~cr ame~e~~ hcMamiMorlt~'f.~'.<<~.f?J~fSeq, General Assembly of It He Sidte of 'Indiana, ;nd all Acts ameh'ditdry
thereto. I further certify that only kitchen, ba, ANArains are connected to the sanitary sewer. I furthh k~hify~that,the construction,win not be
used or occupi until a Cer ficate of Occupancy has been issued by the Department of Community Service;:-Carmcl, Indiana. \
-?'p l If /I- 0 '-IS L------------Tl- I7-:# G
Slgnatu Print" Date
OFFICEUSEONLY:************************************************~~********************
Filing Fees: /;..;2 0
INSPECTIONS REQUIRED: d
Base Inspections: "77. ,5'0 # Charged Re-
O'nder Slab ) Reviews
_ Cert of Occupancy: 5 3 _ SO
S~ P,R,LF,: 1:2 /,/ 00 Additional Fees
~TOT~ : -!%3J?-2'
(',~ ftt<:....e-- 5- 2,,-o~ &?Cf-----J);; /
Reviewed/APpr~: d'ept. of Community Services (Date) . , ~
S:Perm!tsjForms{ILP RESIDENTIAL Fee Received by: