HomeMy WebLinkAbout06080094 Application
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City of Carmel/ Clay Township Permit #OhOR bo9f
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, 8< Tw Family: New Structures, Additions, Remodels, 8< Accessory Structures
BUILDER of
RECORD:
NAME
c.sm'Db~ (]rc
.~FAX
8';;l-:<tt-S,
CITY
T~~RJI\<.t. ~\vb... ~~ Zoo
~lIId
STATE
IN
ZIP
t./~() 3 z..
FOUNDATION TYPE: (Check all that apply for the new
Manufactured
")( y _ construction area)
_ Y _N Trusses: N (
o CRAWLSPACE 0 POST & BEAM j Q, '^
Lot Split: _ Y -$-N Sump Pump: ~Y _N 0 SLAB ~ BASEMENT q ~OJ .
Does any part of the property li.e I(Vithin a special Flood designation area: _ Y $N -:::-~A!iKRU;7:;:::::-,::-~~: N f
. ."-'1 . . .-) U, \'.:.-::' .Ij \: L'=";. \1 i U
For Smgle Family ).l~.t w2 arrll!y' w~!ILn~, a It!O S~~f~ ,iWd/or accessory structures, thIS per~I~__~~~lLa.oiily~ltl~ fOr9,tpences
within 180 days Q4: Qi;1 gr't~mR!~NHe~ I t-JiMhel!na''fuust be complcted (Certificatc of qscupancy issucd) within 18 ~oq.tllsiof the
issuance date. Class I srruct&fe$1atRltimd ~k CA. ~neral Administrative Rules of the Stat~ ?fl~~iana (See 675 lAC 12) regard,i~ ~iration
. DEPT OFCOMMUN'P"f\t"8~j!l/I;Il6~~g and completing constructi?Pi \' \ AIIG 2 9 2n06 I Ii III
T, the undersIgnecl.~~ W~w:. ).opt>trJ-lP1i-ory, 'ffP~~,~iE8~' relocatIon, or alteratIOn of a\sl:fU~ture, oPa11y diange In the use ofla.Iilor
structures requestUltty Ih~p~KM~\eom~, !M~~tT?t\i:>>,1ill applicable la\vs of the State ~(lnt+a, and the "Zonin&.. OrdinaD.4~oft~mel
...-.Indiana -1993~ (Z~ 289) and amendmenttf'fE)!pA~er authority of LC. 36~7 et seq, General Assembly ofttEe StJte- u[ 1ll0lana, and all Acts amendatory
," thereto. I further certify that only kitchen, bath, and floor drains are connected to the sanitary sewer. I further certify that the construction ~ri be
1..: used or cupied u il a Ci r nl:ate of Occupancy has been issued by the Department of Community s,b:v~, C.., "KI, Iudlana.
I?vlsz,J \T, IJ ,,j..;e/6
OFFICE USE ONLY: ******************************** ************j***:t.~**'f***** *************
Filing Fees: II- S 0<-0
INSPECTIONS REQUIRED: ' ___
~. =- . Base Inspections: .,.:) '77. ) U # Charged Re-
Upper Footi ~er FO~-' Under Slab ~J >() ReViews
_ - ~ ) Cert. of Occupancy: .
Rough In . ~a~~:<::al / P.R.I.F.: /;) G/ 00 Additional Fees
TOTAL/ c? '1tf1..o<.C
If1 . rl
'1'fl/ fJ&
STREET ADDRESS
I..,
BUILDER'S EMAIL ADDRESS
HifJ,.WI.s.( e. l.STRII\C.e. ,NeT
PROPERTY
OWNER:
NAME
~ S 'rRibb
STREET ADDRESS
LOCATION
8< PROJECT
INFO:
SUBDIVISION NAME I
6ltIWD;,1 I..,. \
ADDRESS OF CONSTRucnON
~~Io l:.AA,.ll);~ ltAIl
WATER UTILITY I
PROVIDER: "~li::me.
LOT #
SEWER lJTlLITY
PROVIDER:
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION I BZA I BPW DOCKET
NUMBERS; TAC DATE(S); ANDIOR COUNTY WELL ANDIOR SEPTIC PERMIT #'S (IF APPLICABLE):
TYPE OF CONSTRUCTION:
~ SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units:
o MULTI-FAMILY
# of Units:
o RESIDENTIAL (For
Additions, Remodels, Etc.)
TYPE OF IMPROVEMENT:
~ NEW STRUCTURE
o ROOM ADDITION(S)
o PORCH ADDITION(S)
o REMODEL
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION
PROJECT INFORMATION:
Early Release
Permit:
Print
BEST METHOD OF CONTACT:
" q-tdSlo
PHONE
FAX
- .~
CITY
STATE
ZIP
SECTION
ZONING:
S-I
\
6l/l./lIe.1
SQUARE ,
FOOTAGE: 7", $ t.
i
I
I^,
""0'$3
ESTIMATED COST OF CONSTRurnON:
(EXCLUDING LAND VALUE) J '1()t) ,tJOD
'-#- CJb08'oo93
(YJaR"+!-
PLUMBING CONTRACTOR:
K. T m {)D/l.e
Plumber's Indiana State License #:
LP~OO'i)t.OSil
':-'
Which plumbing codes will be applied to the construction:
~ International Residential Code w/lndiana Amendments
o Uniform Plumbing Code w/lndiana Amendments
(Multi-Family Construction Code)
5-/10- ole>
Date
r'yI.J....\;,\;; t1.;s~ Q-{,-06
Reviewed/Appr ed: Dept. of Commumty Services (Date)
S:PermitsjFOfms/ILP RESIDENTIAL