HomeMy WebLinkAbout07020035 Application
City of Carmel/Clay Township Permit #:010760~5
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
& PROJECT
INFO:
SEWER UTILITY
PROVIDER:
FAX:
ZIP:
(PUS 2-
orAT~ 0
_ BEST f1ETHOD OF CONTACT: \
t:VVl4JL: L blClNESQrlK'1\!,
~. cow1
~8'\
SP~ ~(o J::".4'Q.M
PHONE:
~I:)-
FAX:
L
WATER lITIUTY I Aj/J I\A >:::J
PROVIDER: {J"{VJ V \ e.L-
SQUARE rA~
FOOTAGE: '( (S L./
ESTIMATED COST OF CONSTRUCTION: J c'" 0
(EXCLUDING lAND VALUE) .?-J, en
ADDRESS OF CONSTRUCTION:
Pf2J~ .r:MeMs.
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY:
N:
SINGLE FAMILY
TOWN HOME
TWO FAMILY
# of units being
constructed at this
time:
D RESIDENTIAL (For
Additions, Remodels, Etc.)
NAME OF lITIUTY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUN1Y WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE):
TAX MAP PARCEL #:
......------.\
, ,
TYPE OF IMPROVEMENT: PLUMBING CONTRACTORN: A-
D NEW STRUCTURE
D ROOM ADDITION(S) Plumber's Indiana State License #:
D PORCH ADDmON(S) ~// .'
~KADD~ON(S)./ // /
/ REMODEL , A;:1\DI\I Which plumbing codes will b\ apPlied,totii;-CDnstructiDn~ -:l, ~
_ Baseme 1"1 hIV \ _~\ 0. ....
D ACCESSORY BUILDING 0 International Residential'Code w"ndr~na Amendments
D DETACHED GARAGE \ : ! l\jv .
D ATTACHED GARAGE 0 Uniform Plumbing code'~l.Indiana Amendments
PROJECT INFORMATIQN:/ D DEMOLmON FOUNDATION TYPE:
Early Release '7~anufactured ./ construction area)
Permit: _Y~ ~russes: _Y_,7
Lot Split: _Y _N Sump Pump: _Y_N
OFFICEUSEONLY:*********************************************************************************
INSPECTIONS REQUIRED: Filing Fees: /33, r;o
Base Inspections: ~ II J #. 00
Upper Footing Lower Footing Under Slab ff.
~, _r ') Cert.ofOccupancy: .73, .C;1J
~"';;gh I~ Meter Base ~ Si~
-P-$.:D1
Date
# Charged Re-
Reviews
P,R,I.F,: /' Additional Fees
~~,/~,t-<9~ 00 _
I
oved: Dept. of Community Services
S:Permits/Forms/ILP RESIDENTIAL
(Date)