HomeMy WebLinkAbout07020110 Application
City of Carmel/Clay Township Permit #~
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:
STREET ADDRESS:
C\~~
V\ s-\c:cY-.
tc..v-~t\
FAX:
IS
CITY:
STATE:
ZIP:
WATER UTIl1TY
PROVIDER:
FAX~~d_~
ZIP:
SQUARE 0
FOOTAGE: 19'5 \a
ESTIMATED COST OF CONSTRUcnON: 0..""'" ""
(EXCLUDING LAND VALUE) -.) I \..J I vue::.
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION I BZA / BPW DOCKET . . , . \ -.l. C A _IL.
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE): W\\SO..... ~e-v,),.- -::::i'-v.:Je-r ~ OJ D2D'Ol
,~
,~,-,_ -L
\.t . eL.<
TYPE OF CONSTRUCTION:/ TYPE OF'IMPROVEMENT:
/' ./- 0:<)\ /' '\
liT SINGLE FAMILY 't' \7 NEW STRUCTURE
o TOWN HOME .' - C\ '\. q/ROO':',ADDITION(S)
o TWO FAMILY.. a. " 0 PORCH ADDmON(S)
#ofuniB'being o/:.v 0 DECKADDITION(S)
construct.l\l'at thi. O/REMODEL
time: ",,-:: .-....""- '" - - _ Basement Finish only
o RESIDENTIA~~fol:~ y 0 ACCESSORY BUILDING
Additions. Remodels. Etc_) 0 DETACHED GARAGE
-~ 0 ATTACHED GARAGE
PROJECT INFORMATION: 0 DEMOLITION
Early Release
Permit:
Lot Split:
Manufactured
Trusses:
LV_N
Lv N
V"/N
-VLN
Sump Pump:
TAX MAP PARCEL #:
PLUMBING CONTRACTOR: ~J...
~ G:-)""~rc..c'\c,,,S CpgasgD1gl
P?~~\I~c~tas ~tDe.; Brian YAAl BcU~
Which plumbing codes will be applied to the construction:
~temational Residential Code w/Indiana Amendments
o Uniform Plumbing Code w/lndiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area)
o CRAWLSPACE 0 POST &
o SLAB .~ASEMENT
BEAM PIER
~1'\Q'\(N )
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures'M~d 0 x.~msp'da ~o. ences within 180
days of the date of issuance of the building pennit, and must be completed (Certificate of Dcc c i~)00ffiit 18' Qn~_.@B.. ,d~. c.et~I~: lass I
structure pennits are subject to the General Administrative Rules of the State of Indiana (See 6 Jtr~~& L~~f!~9Jb~.. d
completing consrruction. ""fl_\\I\\'.A\j~ttl; ...,:../""\\~t\\St\\
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alteration ~l~nr ~}~e il} thetu~l~"lrUctures
requested by this application will comply with, and confonn to, all applicable laws of the State of IndiaJJ,1in' t ~:zpnm~~ck ~f"~-;l Indiana - 1993" (Z'
289) and amendments, adopted under authority of LC. 36'7 et seq, General Assembly of the State of I~ M~ ame~\f)\A~ I further certify that only
kitchen, bath, and floor drains are connected to the sanitary sewer. I further certify that the constru~~~ -~ill not be used chi ~cupied until a Cernncate of
ccupan has been issued by e Department of Community Services, Carmel, Indiana.
- - \rr~\Cr Z,\\.o..-S A~
Print '
OFFICE USE ONLY: ******************************~~*********************~j**JJ()*~*O ****************
INSPECTIONS RE UIRED: Fllmg Fees: ,( fJ- jI
_ - _ Base Inspections: (1.'11 {O
pper Footing ower Footing A
Cert. of Occupancy: S 3 . ;).JI.
. 0
k, 3:AoO
'2-'2.
(Date)
"7
~
Reviewed/ Ap roved: Dept. of Community Services
S:Permits/Forms/ILP RESIDENTIAL
Fee Received by:
:J::k':,-Uf
Date
# Charged Re-
ReVIews
Additional Fees
Date