HomeMy WebLinkAbout06120008 Application
\
f;ity of Carmel/Clay Township Permit #:IJ&/ ~iY
\ESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
\ Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
'PID
w
G,
PHONE:
317
co -(, 300
FAX:
S 301
ZIP:
41. 5'0
__",i:R
OF
RECORD:
NAME;
-Dr
CITY:
'"I;JD \S
STATE:
.....LN
BUILDER'S EMAIL ADDRESS:
BEST METHOD OF CONTACT:
PROPERTY
OWNER:
1" (~ E;
FAX:
Eo
N
Ak.
PHONE:
I()S-~
'"
LOCATION
& PROJECT
INFO:
STREET ADDRESS:
S LOST
0"
STATE:
::r-",
ZIP:
c.k
SEmON:
o E
ZONING:
. SQUARE /
FOOTAGE:
FLOOD ZONE AREA DESIGNATION(S) ,
FOR THIS PROPERTY: ZO",G X Sho.d ~
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT:
)/ SINGLE fAMILY 0 NEW STRUCTURE
o TOWN HOME 0 ROOM ADDITION(S)
o TWO fAMILY ~ PORCH ADDITION(S)
# of units being 0 DECK ADDITION(S)
constructed at this 0 REMODEL
time: _ Basement Finish only
o RESIDENTIAL (for 0 ACCESSORY BUILDING
Additions. Remodels. Etc.) 0 DETACHED GARAGE
o ATTACHED GARAGE
PROJECT INFORMATION: '"fL,1 0 DEMOLmON
Early Release ,~ Manufactured /
Permit: _Y ./ N Trusses: "-V_N
Lot Split: _Y/ N Sump Pump: _Y......-N
SEWER UTILITY b' ',eQ!;ir.Pf CONSTRUCTION:
PROVIDER: U je t (t;)<€YImNGi1AND.li~ST. "
NAME OF UTILITY EXCAVATION CONTRAcrOR; PLAN COMMISSION I BZA I BPW DOCKET D Pi ;jtato and L I all regul ' "
NUMBERS; TAC DATE(S); ANDIOR COUNTY WELL ANDIOR SEPTIC PERMIT #'S (IF APP : ~ OF COM Oeal COdes, atlons"
Ru'A4if4t! ffW:,EL: E. FMe. .';s' '.;! \::>>~'.'\~\
'-'LAY TO".. ~ )"c/ \\\ \'1\
I. ~. , ,_ -' ,'. ' , , \ ,
PLUMBING CONT' ,'OR; >2 .' iJIQ \~~ \\
, \' __ c. 'l\J \\/ \
, \\ '\ '-l ^' \
Plumber's Indiana State Ueense ..r).' /' ./
,,(.;\ \ '(jV /' //
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Which plumbing codes will be applied to the construction:
\\.0> ~_-
o International Residential Code w/-Iriii'iana Amendments
~ //'
o Uniform Plumbing Code w/lndiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area)
o CRAWLSPACE
j1f SLAB
o POST &
BEAM
PIER
o BASEMENT (WALKOUT:_Y_N )
For Single Family and Two Family dwellings. ad
days of the date of issuance of the building pe
structure pennits are subject to the General Administ
-o/;
..............Oate
~
OFFICEUSEONLY:******************************~~*********************~~O*~********************
INSPECTIONS REQUIRED: FIling Fees: / d-
;:),:;J.;J cO # Charged Re' ~
Reviews
S-3 )cl
Additional Fees
Meter Base
Base Inspections:
Cert. of Occupancy:
Upper Footin
P.R.I.F.:
--' '73~
,
5J-
/
TOTAL:
Reviewed/Approved: Dept. of Community Services
S:Permits/FormsjILP RESIDENTIAL
(Date)
Fee Received by:
Dat'