HomeMy WebLinkAbout07020007 Application
ty of Carmel/Clay Township Permit #:frft>::J. noo' 1-
AESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
b. JER
OF
RECORD:
NAME:
STREET ADDRESS: I 1\ U
/. !5f) N 'HST ~~y)
.f~rt
BUILDER'S EMAIl ADDRESS:
PROPERTY
OWNER:
NAME:
STREET ADDRESS:
LOCATION
& PROJECT
INFO:
LOT #:
~
SEWER LJTILITY
PROVIDER:
6
NAME OF LfTILIlY EXCAVATION CONTRACTOR; PLAN COMMISSION I BZA I BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPUCABLE):
FLOOD ZONE AREA DESIGNATlON(S)
FOR THIS PROPERTY:
TYPE OF CONSTRUCTION: . TYPE OE IMPROVEMENT:
~ SINGLE FA~I" y-;;=;::si ..:,.....\.~E~;STRUCTURE
o TOWN HOI"IL'; '.'< ..,c:>.- 0 'ROOM ADDITION(S)
o TWO FAI"IIL Y '. ,:.> ", .P PORc'li ADDmON(S)
# ofuni~,being ~\)\lIP D.~'g<!ipDmON(S)
constructed at tl\i!\1 ~ '\ 0 REMODEL
time:., f ,,\ \ r'C.u - ----2 Basement Finish only
o RESIDENTIAL'(For ~ ACCESSORY BUILDING
Additions, Remodels"EtC,) 0 DEl'AcHED GARAGE
.' . -
, ' ___0 ATTACHED GARAGE
PROJECT INFORMATION: 0 DEMOLmON
~".4.,.N. ~_N
Early Release _Y /N Manufactured
Permit: Trusses:
Lot Split: -y~ Sump Pump: _Y.;.LN
BEST METHOD OF CONTACT: Efno.; led
PHONE:
FAX:
:.:.;;.--
CITY:
STATE:
ZIP:
srom:t.f-A
ZONING:
3/a
DOG
#:0'7 Od- 6bb<p
PLUMBING CONT~~ .
1- D . {J tJv(5
Plumber's Indiana State License #:
1607~~3
~IUmbing codes will be applied to the construction:
temational Residential Code w IIndiana Amendments
niform plumbing Code w/lndiana Amendments
FOUNDATION TYPE:
construction area)
~WLSPACE
o SLAB
(Check all that apply for the new
o POST &
BEAM _PIER
For Single Family and Two Family dwellings, additions, remodels, and/or ac~~~, fi\, ' S la-'I" \9",~on commences within 180
days of the date of issuance of the building pennit, and must be completed ~~f'Q~~~M) ".tf1 onths of the issuance date. Class I
structure pennies are subject to the General Administrative Rules of the StatsUbi~l~ ~~ '!:t~9~frames for beginning and
completingconstruct<ghStat!) t-..\\"0i S R'II\,.It;W
I. the undersigned, agree that any construction, reconstruction, enlargement, relocati2!l~lfef,!:iifTt~'1th.\Ut~bf ab.~ ~~~R land or structures
requested by this application will comply with, and conform to, all applicable laws iJ)tbd-S&.t~tjn?,~~ t;I G~~ otdrrQhU orCarmel Indiana - 1993n (Z~
289) and amendments, adopted under authority of LC 36-7 et seq, General Assem.bl:i~('5A'iit~a'h~~allbf-~ amendatory thereto. I further certify that only
kitchen, bath, and floor drains are connected to the sanitary sewer. I further cert~\ha\: ttte 'constrUctio\N1DW"BrtJ.sed or occupied until a Certificate of
Occup cyhas beep issu by the Department of Community services,' C .-~ lnel, I~ndiana ('- V IT\/' "
---1___ gl'i=:f. ~~gl-{)7
pnnt ' Date -}-
OFFICEUSEONLY:*********************************************************************************
INSPECTIONS REQUIRED: Filing Fees: 70 I , bn
n.: ' i) L F' U d SI b Base Inspections: c1/71, 50
~pper Footing ower ootlng n er a 5D
~ ~~a'""') Cert, of Occupancy: .5'3,
ev~/ ~ P,R,LF.: - I, '2.6/,00 Additional Fees
/ : ~TAL: ' 7 -.#:;1(93,
~;?d '
"'7 ,.s .
(Date)
S:PermitsjformS/IlP RESIDENTIAL
# Charged Re-
Reviews
Date
Fee Received by: