HomeMy WebLinkAbout07010072 Application
City of Carmel/Clay Township Permit #:0'7 OJ tJO 7 J-.
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory StrJctures
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BUILDER NAME: PHONE: FAX:
OF !-t//L Lilt c9~a/;/v?l/ ..j-;?6-i'1..5?
RECORD: STREET ADDRESS: CITY: STATE: ZIP:
J//'I i/vElluRSj- lJR... C/l-I2-/0 EL- I/Y 7'b,()3~
BUILDER'S EMAIl ADDRESS: BEST METHOD OF CONTACT:
!vILLi ?vi. C/TLLI/lUGII tf! VERI ZL'>N. /VET ?If{)/'Ie 8'A/lA-IL
PROPERTY NAME: PHONE: FAX:
OWNER: tV / L4rf. tJ-/TU- / #(/?j! ~P-1~
STREET AODRESS: CITY: STATE:
P; Nelfu,e.s-r D~ () /tI2A1l? L //'1
ADDRESS OF CONSTRUCTION:
::<.; / ? Ni:7/IV ~ DfC...
SEWER UTIlITY cL-fr'T Tk/tf.:Y/f 7" WATER UTIlITY
PROVIDER: ~61' I PROVIDER: /?L LJ I IL.-l
NAME OF UTIlITY EXCAVATION CONTRACTOR; PLAN COMMISSION I BZA I BPW DOCKET
NUMBERS; TAC OATE(S); ANDIOR COUmY WELL ANDIOR SEPTIC PERMIT #'S (IF APPLICABLE):
LOCATION
& PROJECT
INFO:
LOT#:
-.5-/
FLOOD ZONE AREA DESIGNATlON(S)
FOR THIS PROPERTY:
TYPE OF CONSTRUCTION:
t
o
SINGLE FAMILY
TOWN HOME
TWO FAMILY
# of units being
constructed at this
time:
~ RESIOENTIAL (For
t Additions. Remodels. Etc.)
PROJECT INFORMATION:
Early Release
Permit:
Lot Split:
~y /N
~y/N
SUBDIVISION NAME:
C ,(!pO
TYPE OF IMPROVEMENT:
o NEW STRUCTURE
& ROOM ADDITION(S)
kJ PORCH ADDITION(S)
o DECK ADDITION(S)
o REMODEL
_ Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLmON
Manufactured
Trusses:
Sump Pump:
y~
y~
w?:,r
SQUARE If QL> :5l
FOOTAGE: /T7J})ITlb,N.
ESTIMATED 'COst OF CONSTRUcnON
CLUDINGlAND VALUE) c2::) !/o ()
(\ '"If"\n"1
vv/
I;,
"
-b3-b3'-!DD y,{)D
,
PLUMBING C~~!RACTOR:
S errT PL/I1 b- <jt-/rff/t-T; N t:-
Plumber's Indiana State License #:
C? '? / f) S-3 f?f? Y
Which plumbing codes will be applied to the construction:
o International Residential Code wI Indiana Amendments
o Uniform Plumbing Code w/Indiana Amendments
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FOUNDATION TYPE: (Check all that apply for thelnew
construction area)
rf- CRAWLSPACE 0 POST & BEAM --,-PIER
o SLAB 0 BASEMENT (WALKOLIT:~Y_N )
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this pennit is valid only if construction commences within ISO
days of the date of issuance of the building pennit, and must be comPl~C~" rJc C issued within IS months of the issuance date. Class I
structure permits are subject to the General Administrative Rules of th a . ation time frames for beginning and
camp .
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or a teratlOn 0 a sere, r c in the use of land or structures
requested by chis application will comply with, and confonn to, all applicable Jaws of the State of Indiana, and the "Zoning Ordinance of Cannel Indiana - 1993" (Z~
289) and amendments, adopted under authority of r.c. 36'7 et seq, General Assembly of the State of Indiana, and all Acts amendatory thereto. I further certify that only
kitchen, bach, and floor drai are c nnected to the sanit sewer. I further certify that the construction will not be used or occupied until a Certificate of
Occupancy has e iss t of unity Services, Carmel, Indiana.
11//'-41"1-/0 M-L-L-/f/-u?/-l-
Print
/ /;t)~")
"'Ie /
OFFICEUSEONLY:*********************************************************************************
INSPECTIONS REQUIRED: Filing Fees: / '{? ? 0
~er Footinp Lower Footing er_Sla~ Base Inspections: /,,? ~
~' -----, Cert. of Occupancy: . e:--,., 0
ough Meter Base Site.....__
P,R.I.F.: . Addibonal Fees
~~O~!~~!~
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Reviewed/Ap roved: Dept. of Community Services
5:Permits/Forrns/ILP RESIDENTIAL
# Charged Re-
ReVIews