HomeMy WebLinkAbout07010104 Application
~
""ity of Carmel/Clay Township Permit #:01(')101 D4
'~aDENTJAL IMPROVEMENT LOCATION PERMIT APPLICATION
. Single Family, Town Home, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
.:R
NAME:
STREET ADDRESS:
.<ECORD:
0,
PHONE:
CITY:
7/ :Ueb
STATE:
Cf ~" 5. 'IN
ZIP:
"'~iJO
BUILDER'S EMAIL ADDRESS:
Dc,v,o\ l;) OBK~ iN, '-0,.....
BEST MrniOD OF CONTACT:
PROPERTY NAME: S PHONE:
OWNER: ~
STREET ADDRESS: CITY:
LOCATION LOT #: SUBDMSION NAME:
&. PROJECT t~ ViI
INFO:
FAX:
STATE:
ZIP:
SECTION:
SQUARE I r-
FOOTAGE: ~, .:> "1
1()()(j)rr-
SEWER UTIlITY
PROVIDER: L.l. R LJl)
NAME OF UTIlITY EXCAVATION CONTRACTOR; PL'oN COMMISSION / BZA / BPW DOCKET C.
NUMBERS; TAC DATE(S); AND/OR COUN1Y WELL AND/OR SEPTIC PERMIT #'S (IF APPUCABLE):
FLOOD ZONE AREA DESIGNATION(S) "
FOR THIS PROPERTY: I'
o CRAWLSPACE 0 POST &
~s~ ~Elro~IObLN)
For Single Family and Two Family dwellings. additions. remodels. and/or accessory structures, ~kJ~.t tf1..!d~u.'if~~~s~<;t~~9BYnenCeS within 180
days of the date of issuance of the building permit, and must be completed (Certificate of Occupancy issud)~~~ ~htA'S6f rt!e1s's1i~fC;.c!i.t. t$-;(I lass 1
structure permits are subject to the General Administrative Rules of the St,ate of Indian~ (See 67~ re~f1.~1}ijtN~&ii>lib~g and
completmgconstrUctlOn. V T(",,\\Nf\.I~""IP
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alteratio~\tteCaAAM61e ~ ~ bflll.l\d l!Ir"s\:~l ~ ,
requested by this application will comply with, and conform to, all applicable laws of the State of Indtt~a: a~d the "Zoning 0rRiw:wA t{~rmel Indiana - 199r (Z'
289) and amendments, adopted under authoriry of LC. 36'7 et seq, General Assembly of the State of Indiana, and all Acts amehlJ1~rYru1ereto. I further certify that only
kitchen, bath, and floor dra' e connected to the sanitary sewer. I further certify that the construction will not be used or occupied until a CeroIia.te of
Occupancy has lssued the D , f unity services'rr:.e~~;"'La, 12' --A U"-,
~y"",_ DGC-J\G.- ,/i/..lt'''1
Si et" or Authorized A Print
TYPE OF CONSTRUCTION:
T;l(. SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions. Remodels. Etc.)
PROJECT INFORMATION:
Early Release
Permit:
_V~N
_V-LN
Lot Split:
TYPE OF IMPROVEMENT:
')l
o
o
o
o
NEW STRUCTURE
ROOM ADDmON(S)
PORCH ADDmON(S)
DECK ADDmON(S)
REMODEL
_ Basement Finish only
o ACCESSORV BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOUTION
Manufactured
Trusses:
_V\iN
~V_N
Sump Pump:
OFFICEUSEONLY:******************************~~******~**************t>*~***}1~****************
INSPECTIO QUIRED: Filing Fees. j, 3. -
F t. L F t'~ Under Slab Base Inspections: c2 '71 .1'0
~oo~ ~OO~ ~
~ Cert. of Occupancy: v ~ .SO
Fi al Site ;.
P.R.I.F.:
Reviewed/A proved: Dept. of Community Services (Date)
S;Permlts/Fom\sIILP RESIDENTIAL
Fee Received by;
, ,
F;.C)JW'<fT,'CY'/
JAN 1 6 2007
, ,
PLUMBING CONTRACTOR,'
b~ 't'Iv-n b".~_u
Plumber's'tI\diana State Li #:
9#/0 u ;J-vL-/
- --------~.J '
../ i
,
--____---.J
Which plumbing codes will be applied to the construction:
~ International Residential Code w/Indiana Am~ndments
o Unifonn Plumbing Code wI Indiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area)
BEAM _PIER
Date
# Charged Re.
ReViews
Additional Fees
Date