HomeMy WebLinkAbout06100147 Application
City of Carmel/Clay Township Permit #:tJ~ 1001if7-
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
,
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Strucl;ures
BUILDER
OF
RECORD:
PHONE:
CaYmd :uJ
BEST METHOO OF CONTACT: 4<0 03;2-
.
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PROPERTY
OWNER:
PHONE:
FAX:
STREET ADDRESS:
CITY:
STATE:
ZIP:
NAME OF UTIlITY EXCAVATION CONTRACTOR; PLAN COMMISSION I aZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE):
SECTION:
ZONING:
LOCATION
& PROJECT
'~:
SEWER
PROVID R:
FLOOO ZONE AREA DESIGNATlON(S)
FOR THIS PROPERTY:
I,(YlS~!e.cl
TYPE OF IMPROVEMENT:
o NEW STRUCTURE
o ROOM ADDITION(S)
o PORCH ADDmON(S)
o DECK ADDITION(S)
o REMODEL
_ Basement Finish only
o ACCESSORY BUIlDII"~'
o DETACHED GARAG'
o ATTACHED GARA(
o DEMOLITION
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TYPE OF CONSTRUCTION:
o SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions, Remodels, Etc,)
PI ber's Indiana State License #:
(71 / (:(XYY I'J I
Which plumbing codes will be applied to the construction:
~temational Residential Code w/lndiana Amendments
o Uniform Plumbing Code w/lndiana Amendments
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Date '
OFFICEUSEONLY:*********************************************************************************
INSPECTIONS REQUIRED: Filing Fees: 'J:.Oc2,?:Y
. _ Base Inspections: ~ -;/'2 ) 0
per FootIng 0 er Foo Under Sla.b_ :; 3 S-rJ
'''y''. Cert, of Occupancy: '
Final Site / 7 {/ (/0
P,R.I.F.: _/7
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# Charged Re-
ReViews
O-G
Dept. of Community Services (Date)
S;Permits!FormsjIlP RESIDENTIAL
Additional Fees
L/()
Fee Received
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