HomeMy WebLinkAbout06100102 Application
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City of Carmel/Clay Township Permit #: ()Ce,! 0 Off);2
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER of
RECORD:
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CITY
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STATE
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ZIP
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BEST METHOD OF CONTACT:
PROPERTY
OWNER:
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LOCATION
&. PROJECT
INFO:
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LOT #
ID
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FOOTAGE:Of~
SEWER UTIL
PROVIDER:
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ESTIMATED COST OF CONSTRU
(EXCLUDING LAND VALUE)
NAME OF UTlUTY EXCAVATION CONTRACTOR; PLAN COMMISSION I BZA I BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'5 (IF APPLICABLE):
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/00/00
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT:
o SINGLE FAMILY~ 'b rl M"
'fZf TOWN HOME -~~~d\ 6
6 ~~/u~7~~Y "tlC;UV- 0
o MULTI-FAMILY 8
# of Units: 0
o RESIDENTIAL (For 0
Additions, Remodels, Etc.) 0
NEW STRUCTURE
ROOM ADDITION(S)
PORCH ADDITION(S)
REMODEL
ACCESSORY BUILDING
DETACHED GARAGE
ATTACHED GARAGE
DEMOLITION
PLUMBING CONTRACTOR:
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Plumber's Indiana State L ense #:
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Which plumbing codes will be applied to the construction:
~_ !ltemational Residential Code wI Indiana Amendments
~,yniform Plumbing Code wI Indiana Amendments
- -(Multi-Family Construction Code)
PROJECT INFORMATION:
Early Release
Permit:
M f ct d FOUNDATION TYPE:
Tr~~~ ure ~y _N construction area)
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sum~~~~ Y _N rxr SLAB
. d designatior/a';a: _Y N
(Check all that apply for the new
o POST & BEAM /.->..
o BASEMENT---'~-;; ,(''1 "'-,
___ _____ r: "",,\.:1 \ r..:f;:. i '
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Signature of Owner or Authorized Agent
Print
ary sewer I further cerufy Ithat the ~9nstructlm;- WIll not be
[Com unity SITices. Carmel;hldiana. ~
Oate
OFFICE USE ONLY: ****************************************************~*******************
Filing Fees: {,.;2eJ.-. bO
NSPECTIONS REQUIRED: '
Base Inspections: ~ 7;' :::0
<5-3. ~O
) .;LGJ CO Additional Fees
/~0217 & 0
Lower Footing
# Charged Re.
Reviews
Cert. of Oeeu pa ncy:
P.R.I.F.:
TOTAL:
Reviewed/Approved: Dept. of Community Services (Date)
S:Permits/FormsjIlPRESIDENllAL
Fee Received by: