HomeMy WebLinkAbout06060212 Application
City of Carmel/ Clay Township W/~ ~ Permit #: ZJ Ce O~.J. fJ.
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER of
RECORD:
NAM/ri
STREET ADDRESS
PHONE
3'1
i
STATE
I j\.I
PROPERTY
OWNER:
CITY
s- _ (~fY'.
PHONE
BEST METHOD OF CONTACT:
'?h()(l.e
FAX
SI\I'I\L
60 J(:.-
STREET ADDRESS
CITY
STATE
ZIP
LOCATION
&. PROJECT
INFO:
LOT #
2-A
SUBDIVISION NAME
SECTION
ZONING:
-Put>
rJ
ML
SQUARE
FOOTAGE: ZrS-O
SEWER UTILITY WATER UTILITY ESTlMATED COST OF CONSTRUCTION:
PROVIDER: C-klZ.-1Vl L PROVIDER: C ~ ('II E 1- (EXCLUDING LAND VALUE) I z.. 0 0 0 0
NAME OF LmLITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA/ BPW DOCKET W ILL ~ IE" c "IIA .,'", iT Df' A-DL5 0'/070 C7 3(.
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE): P<J D _ -L{ Z. _ 0 ~ () L./ /:) 7 0035 ~
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT: PLUMBING CONTRACTOR:
o SINGLE FAMILY ~NEWSTRUCTURE "PAUL.. E: 5Mlrl-l
~OWN HOME 0 ROOM ADDITION(S) Plumber's Indiana State License #:
. 0 r:~f~~~~~Y 0 PORCH ADDmON(S) c..:P BID I -:ri-1- I
o REMODEL
o MULTI.FAMILY 0 ACCESSORY BU1LDING
# of Units: 0 DETACHED GARAGE
o RESIDENTIAL (For 0 ATTACHED GARAGE
Additions, Remodels, Etc.) 0 DEMOLmON
Which plumbing codes will be applied to the construction:
~ International Residential Code wI Indiana Amendments
o Uniform Plumbing Code w/lndiana Amendments
(Multi-Family Construction Code)
PROJECT INFORMATION:
Early Release
Permit:
Manufactured
Trusses:
,]LY _N
FOUNDATION TYPE: (Check all that apply for the new
construction area)
_Y-to-N
Lot Split: _Y -,XLN Sump Pump: _Y-p'-N
Does any part of the property lie within a special Flood
o POST & BEAM
o BASEMENT
"'l.
OFFICEUSEONLY:**********************************~**********'****1'********************
Filing Fees: La 0:1 . (9 0
. INSPECTIONS REQUIRED: n rl1 "'0
Base Inspections: "" I . ~ # Charged Re-
^' ReViews
Cert. of pccupancy: S 3 , 00 'cf .
P.R.l.F.: /I ct 8t Additional Fees
. '35 00
ett
Reviewed/Approved: Dept. of Community Services (Date)
S:Permits/FormsjILP RESIDENTIAL
Fee Received b .