HomeMy WebLinkAbout07020004 Application
City of Carmel/Clay Township Permit #:O-~O~bOOi=-
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
for Single family, Town Home, 8r. Two family: New Structures, Additions, Remodels, 8r. Accessory Structures
BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
8r. PROJECT
INFO:
SEWER UTIlITY
PROVIDER:
PHONE:
C-. c:
:J
d.350 X ,JOb FAX 575,.f15D
&L f/.:0{)3:J-
NAMEPUL Tt;
TI~AqOS: N . 82.1 D i AN .sA
BUILDER'S EMAIl ADD~ESS: . /1/\ /""\
.JOAN rJE- ,..s HE PH E~ (.!;' Pt,U.TE ,Ci)r1
NAME S-At'V\b
Manufactured
Trusses:
~N
V"'y =N
HOI0E5
STREET ADDRESS:
SUB~IVISION NAME:
LO IL.l f..)(1S eSTATES
An7s~(rSTRucn,JNfJ I tJ {; HAM
WATER UTILITY
PROVIDER: C AQJv, EL
L~l
RE Gr .
CITY:
PHONE:
FAX:
CITY:
STATE:
ZIP:
SECT! N:
ZONING:
s- t
00.
SQUARE I
FOOTAGE' -h'~1 3
E51lMATED COST OF CONSTRUC1J9N:
(EXCLUDING LAND VALUE) -11-- I ;);;.
A \ SuPE/2.LOP-- 5X r:.. ,-*07020003
NAME OF UTILITY EXCAVATION CONTRAaOR; PLAN COMMISSION I BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNlY WELL AND/OR SEPTIC PERMIT #'5 (IF APPUCABLE):
FLOOD ZONE AREA DESIGNATION(S) 1\ 'i: Ii
FOR THIS PROPERTY: . .- '. ,"
..-~ c" ~. c.~ \ '. '. \ \
TYPE f CONSTRucn6N:\~j ):::-..,.yPE'OF IMPROVEMENT:
SINGLEF!ihI~ :::S~., d\\N~ STRUCTURE
o TOWNHO~~.;:/ '\\$\ tJ\\'t091(l ADDrTION(S)
o TWOFA,,!,LY \ 'l.\.i 0 \PORCHADDrTION(S)
# ~~ ~?~ be~~ .. O.--DECK ,\pDrTION(S)
constructed ~U;,,, ~ REMODEL
time:' \ \\. ~ ......"'-/Basement Finish only
o RESIDEN:nAI: (For________.e:J.-- ACCESSORY BUILDING
Additions..\RemoClels. Etc.l,.._-- 0 DETACHED GARAGE
\ .---------- 0 ATTACHED GARAGE
PROJECT INi=oRMAT"xON: 0 DEMOLITION
./
_Y_N
_y_'1f
Early Release
Permit:
Lot Split:
Sump Pump:
PLUMBING CONTRACTOR:
~ YYl ~-S0tJ.!1
Plumber's Indiana State License #:
CP IDOOOIO)
Which plumbing codes will be applied to the construction:
uz( International Residential Code w/lndiana Amendments
J Unifonn Plumbing Code w/Indiana Amendments
fOUNDATION TYPE: (Check all that apply for the new
construction area) FWJ... UN FI tJ IS: H EtJ /JY4A/J
o CRAWLSPACE 0 POST & BEAM PIER
o SLAB W"BASEMENT (WALKOUT:_Y ~
For Single Family and Two Family dwellings. additions, remodels, and/or accessory struet . o. I"lIti ionco~~ within 180
days of the date of issuance of the building pennit, and must be completed (Certificate of 8tg~~th1RaAMJ M llftGUlf:ltt'~'lBte. Class I
structure permits are subject to the General Administrative Rules of the State of Indiana (See 67~ IAC::of:St'ateliY8SXRi.l1@1Ji~lII9rnes for beginning and
completingcon'trllction, .'IIl-dI1"V ~t:O\lI""J::S
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or altenDEi?LQJfu~Ot4~Hmge lrl the ~h'nan~r-m:w~ures
requested by this application will comply with, and conform to, all applicable laws of the State ~r.vDP~fi'~Qr?i~~W~I"J. (Z'
289) and amendments, adopted under authority of LC 36,7 et seq, General Assembly of the Sta~\nfiia'tfa~ an~aItAct~~we..!.A'der..orrtfhereto. I further certify that only
kitchen, bath, and floor drains are connected to the sanitary sewer. I further certify that the construction will not be IUseaJ~Uf'ied until a Certjficate of
Occupancy has been iss by the Department f Community Services, Cannel, Indiana. .
/ I' \. JOAt-J11E .s l1E:P\-\E:/2D
Print
SEONLY:******************************************************
F'I' F a 0
INSPECTIONS REQUIRED: IlRg ees: . ,) --? '. c-O
.ru;. .-<: ~) Base Inspections: ~ oJ l
~per FOO~ L~er roo~ Under Slab 5::'. ,)'0
Cert. of Occupancy:
~) ("1ete~ Final Site P.R.I.F.: / d 1 j. ()O
, p; ;;'St,Y: 3 0
-01
OfF
'?-/I 10'7
D.te
# Charged Re-
Reviews
Additional Fees
'2'1-0
Dept. of Community Services (Date)
S:Permits/FormS/ILP RESIDENTIAL
F
Date