HomeMy WebLinkAbout06100136 Application
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City of Carmell Clay Township Permit #: 0 ~ / OQ f 3 &
!
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER
OF
RECORD:
NAME:
....-
~t
STREET ADDRESS:
u,III.-
PHONE:
3/=1- - \o(,'{
FAX:
)1 -g,,'!-JYflz..
CITY:
F,'.<lJ ~r.u- hJ
STATE: ZIP:
I:/V' 'i (,. 0 J 5
BUILDER'S EMAIL ADDRESS:
~
PROPERTY
OWNER:
NAME:
G{w.r
,
~r/J-/r. A.' "iJ,/ '
CITY:
WA. +ft',d
STATE:
5:..".;
SECTION:
ZIP:
Y6()~
STREET ADDRESS:
b tJ,'d.
,
Dr
LOCATION
&. PROJECT
INFO:
LOT#:
SUBDIVISION NAME:
vii"
.
ADDRESS OF CONSTRUCTION:
G 1'1 t ,U 5~.
SEWER lmlITY WATER lmlITY Ob/,' /
PROVIDER: C{ l', ILl. ((I." ( PROVIDER: (" ~.rt ~
NAME OF lmlITY EXCAVATION CONTRAcrOR; PlAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNlY WELL AND/OR SEPTIC PERMIT #'S (IF APPUCABLE):
PHONE:
BEST METHOD OF CONTACT:
L,~ , '1ie-)'O,,"
FAX:
/~
1+ 5'7-1-7+1-.7
o
ZONING:
p
SQUARE
FOOTAGE: 0
if,
ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING tAND VALUE) Jt '16 0
O"\D
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY:
rJA-
PE OF IMPROVEMENT:
\ ~ NEW STRUCTURE
~ 0 ROOM ADDITION(S)
o PORCH ADDITION(S)
o DECK ADDITION(S)
o REMODEL
_ Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION
TYPE OF CONSTRUCTION:
\<l.. SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions. Remodels. Etc.)
PROJECT INFORMATION:
l(p,r,& ~""UlJ <{-,I.
TAX MAP PARCEL #:
PLUMBING CONTRACTOR:
(wrf- N(..(
Plumber's Indiana State License #:
pc.. Iql,.DO/ooo
Which plumbing codes will be applied to the construction:
Il'ilIntemational Residential Code wI Indiana Amendments
o Uniform Plumbing Code wI Indiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area)
Early Release Manufactured
Permit: _Y ~N Trusses: _Y .t., N 0 CRAWLSPACE 0 POST & BEAM _PIER
Lot Split: _Y ~ Sump Pump: A-Y _N 0 SLAB ~ BASEMENT (WA:~OUT:..__.y,xN )
For Single FamilY~~:'l,~it'~I~ _ e . _... ~ _. ._.:p.ons:r~ pl" ffldl,gr accesso,! structures, this ~i\'i~ ~d @,(~sBubti~n ~~f~~~;~, within 180
days of the date @~tll)f tlw :b~l:i.mg.~'t,,railll mu~~ttTImp~ted (Certificate of Occupancy,lssued):.wtthiri'IB montlis of-thelssuance date. Class I
structure permits are subjecb~a.&e~~ ~~mIPisfilitiVeRules of th'e,State of Indiana (See 675 IA6:I\l) ~ding expiration time frames ~~r ~ginning and
~' 1:nLf.:>= R\/leeSeting construction. i I ~ \ \ Iii I II
I, the undersigned,'[igreRit.tQfc~Ji~l, nstrUct1'O~~nlar~e.mfqt;. \ location, or alteration of a sn:u'ct;Jr~, or anY'Rhlfngeln fJ.1e O.&Ji11and-qr stfl;l4tures
requested by this f1P~i~ wiIC.~l&1:Jre, C~)fn TdJWWpl:t:nI5IJ a s of the State of Indiana, an~ 'r~e\"~oning-ljMinance of Cannel Indi~J}Q93" (z-
289) and amendm't-riH, atloptM under aurr~~ of r...C;..J6-7 et seq, G~neral Asse bly of the State of Indiana, a~q aIt~cts amendatory thereto. I furthJr certify that only
kitchen, bath, and floor drains are connecWf1!olJ~.k':Mfl:a sewer. I further cert that the construction ~Il not be use&or occupkdCiintilaCertificate of
Occupancyhas been issued by the D p ment unity Senlices, Cann . Indiana.! 1
~ . ')0 w,llr,_ L---.----------fvl-,.;;Db
. Print Date
INSP~CTIO S.RE_QUIRED:
<U;pe7F~o~ LowerFooti~ Under Slab
~ - ~,. ~
~ Rough In Final Site
l \ C~ft 11/~ lo~'Z3-ot.
Reviewed/Appr ed: Dept. of Community Services (Date)
\Penmts/FormS/llP RESIDENTIAL
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,00
:;1."17,<0
Cert. of Occupancy: S-3 , .:50
P,R.I.F"L;: ! J. b! 00 Addiuonal Fees
L-, , TOT~Z7 d /1h2bS,b. to
~Xt/N:rPd~
Fee Received by:
i1ing Fees:
Base Inspections:
OFFICE USE ONLY: *********
# Charged Re-
Reviews
Date