HomeMy WebLinkAbout06100013 Application
City of Carmel/Clay Township Permit #:.D.k\12..1Jl2l'3
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
&. PROJECT
INFO:
SEWER UTIlITY
PROVIOER: C LA
NAME:
'J e F'
FAX:
ot 3
7
PHONE:
51 { 8'19-
WJv(]:fje,r p(ITY~ . C,>
L.
STATE:
TN
ZIP:
L/(, z..~o
BE METHOD OF CONTACT:
7 8-(,.-0 @. .5 Be G LOtoc.c. . r-}e.
BUILDER'S EMAIl ADD~~SS:
/3 '^- i L- 01; er
NAME:
t.../z-
PHONE:
;] (7 -.538- 57 'I (
FAX:
J-o Le
LOT #:
W.:.tl~
SUBDIVISION NAME:
L..ex \ 7J
'Ff;vr WlS
ADDRESS OF CONSTRUCTION:
/ /2- 0 f\ ~CJ! lA.-CI
c.
CITY:
Ccvr .meL
STATE:
IN
ZIP:
<)1;7.2,0
fO<.VV S 1..<
w""-
SEmON:
ZONING:
~~
CjLfO
SQUARE
FOOTAGE:
. -
o-t'tQ)
ESTIMATED COST OF CONSTRU
(EXCLUDING LAND VALUE)
NAME OF UTIlITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE):
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY:
TYPE OF CONSTRUCTION:
~ SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
.y; RESIDENTIAL (For
Additions. Remodels. Etc.)
Early Release
Permit:
PROJECT INFORMATION:
~ CRAWLSPACE 0 POST & ./ .B!'AM _PIER
o SLAB 0 BASEMENT.(WAlKOOf,>.\ Y_N)
___~, n \';~_ \\ " \\
For Single F~llmdt 1~i~llxi~Y'\~~{l'fI~Wf1~' [.til!~andJor accesso~ structures, this pe~is'~19~~~~~hs1hkti~ ~ ~ ;'n~s within 18:0
days of the ""date t{risSu~~2t dieRwtamg,p,e~t"l. must be completed (Certificate of Occup~cy..!.S;'>ued),.W1~ 18 mOhths of the lSSU. c~\~~te. Class 1:
structure permits.are ~~J~ti?thv Ge~tarNdr6'tftl's dt'tive Rules of the State of Indiana (See 675 IA.~p)'{b~in~piration time ~ame~ f~r ~ing and
fi1PT OF COMMUNITY SERVICESompIetingconstruction \\' \\~ ~~'\l'o I\) j \~ I
I, the und~?i: ~E t~t;..3fl}'"cfllSFrutt~, 9t\9""'~tA~~mRfent, relocation, or alteration of a st~~t1l[ oran~~ge.m ~e tse of land ~kcfuc res
requested ~ ppwatil:mktrn ~ Wt!l:f,~ \:mHbn"X ~d,l!'PJptmcable laws of the State of Indiana, ari~~, ninMkd\nance of Carmel . a - 199 .. (Z~ ,
289) and amendments, adopted un~~f}OfNiAf LC. 36~7 et seq, General Assembly of the State of Indiana, a\ld\al\~~ts amendatory th . further certify. at only
kitchen, bath, and floor drains are connected to the sanitary sewer. I further certify that the construction 4\~O~ used 0 upied until a Ce . 'We of
Dc ancyhas been issued by the Department of Community Services, Cannel, Indiana. ,\) .
~ .J c::F 1- A r- M"-G '''if /vh-/c>t,.
Date' ..
Lot Split:
_Y~N
_Y2s1N
vtT1/5
TYPE OF IMPROVEMENT:
o NEW STRUCTURE
~OOM ADDITION(S)
o PORCH ADDmON(S)
o DECK ADDmON(S)
o REMODEL
_ Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOUTION
Manufactured
Trusses:
_Y~
_Y "'N
Sump Pump:
OFFlCEUSEONLY:******************************~~*********************!~**~~********************
INSPECTIONS REQUIRED: FIling Fees: ;J .3 /-..-2 ()
/'1lo; Base Inspections' / (; h .) 0
~per FO~ lower Footing Under Slab . ./rJ
~' Cert.ofOccupancy: ,73, ,;J
~Ugli 19 Meter Base Finar' Site
. . P.R.I.F,:
r yS'~ 30
Print
TAX MAP PARCEL #:
PLUMBING CONTRACTOR:
'It 1'1Z-!l/A *-
Plumber's Indiana State License #:
Which plumbing codes will be applied to the construction:
)X( International Residential Code wI Indiana Amendments
o Uniform Plumbing Code w/Indiana Amendments
FOUNDATION TYPE: (Check all that apply for the new'
construction area)
# Charged Re-
ReViews
Additional Fees
(Oate)
Fee Received by:
Date