HomeMy WebLinkAbout07030121 Application
LOT #: ~
2--'7 5
ADDRESS OF CONSTRUCTION: SQUARE '7 ? 1(
t'i r.5 (>'V' FOOTAGE:
SEWER UTIlITY l:"''''''-''~W WATER UTIlITY /' II '- J f , ::;>
PROVIDER: f '0 PR~~I~~(\, ~I We<. f-VV // ~~92: 0 0
NAME OF lITlLITY EXCAVATION CONTRAcrO~;,P~N:GQt:1M1SSt~j BZA / BPW DOCKET 0 030 ~o_ Ii <1i~/ 'I'~ (?~',.."
NUMBERS; TAC DATE(S); ANDIOR COUNTY WELL ANDIOR-sEP:nG.P.ERMIT #'S (IF APPUCABLE): U 7' A A /V' t;; vr.h'J,;). 'J. Nij_~:O i7::,',
_,,<..-:::> \\ -"':'1/ \\ \\ l.>/\.PI,...-- ...., ;/77, fW .... -:,:.", ,':'
FLOOD ZONE AREA DESl.GN~llOt(tS)';>rJ \0:Y \~ TAX MAP PARCEL #: /!/ 1/.,/ JJ
FOR THIS PROPERr;<~'\~{~_/' ,\ / ':{: "'411
TYPE OF CONSTRUrn - N: PLUMBING CONTRACl()R:, "')_.. . .9 lOt
SINGLE FAMILY~.J ~ ~~<?:. STRU9 E fl. (?, .)J.cksoJ PI"'::!"!:>. ';v,{ 0/
g ~~~:~~~~\\\\ /.g.... :~~H~~~J~~) Plumber's Indiana State License #: "'" '-....,,;'
#ofunitsbein~~'0V D/OECKADDITION(S) Pc d"'<pq -cn:>t)g 0 ~'-
constructed at thi~/D REMODEL .
Which plumbing codes will be applied to the constructio~:"....',
time: Basement Finish only "
o RESIDENTIAL (For 0 ACCESSORY BUILDING 0 International Residential Code w /Indiana Amendments
Additions, Remodels, Etc.) 0 DETACHED GARAGE _ ./'
o ATTACHED GARAGE lU'Uniform Plumbing Code w/Indiana Amendments
o DEMOLITION
BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
&. PROJECT
INFO:
City of Carmel/Clay Township Permit #: D103ol~ \
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
NAWI()"~l \ CoNS
0.1
PHONE:
~c~ 57 'f ~ (Cj
CITY:
~ o..AJS-v;!Ie ...k.J
FAX:
Si"iJ-o
STREET ADDRESS:
STATE: ZIP:
5?.::>7
BEST ETHOD OF CONTACT:
c-<. It. /lJ-c I-
PHONE:
FAX:
NAME:
STREET ADDRESS:
STATE:
ZIP:
CITY:
SECTION:
ZONING:
Vo2...-
Early Release
Permit:
PROJECT INFORMATION:
V /N
vv1J'
~,r..y'
Manufactured
Trusses:
Sump Pump:
_V v(
FOUNDATION TYPE: (Check all that apply for the new
construction area)
o CRAW\\~~\O~\~ PCST & _ BEAM ~R
?-re~.\~~fNT (WALKOUT:_V_N)
Lot Split:
-0_N
For Single Family and Two Family dwellings, additions, remodels, an~~.~ '... "".,. ~. ~ ~~t{;QhJ:il!'~" " . ctioD commences within 180
days of the date of issuance of the building pennit, and must be comp~. ~..'.~~. .?fPo ~~\1Lli~)~., "",1~ ;"~...'.'." \"i1f the issuance date. Class I
structure permits are subject to the General Administrative Rules of tllft~"..~,!g~,~fj~;. _ e. o7SJA\Q~) hRf~. ~?ri time frames for beginning and
completmgcons~<@,ON\\\j\".': r.\..,p\-~> -, ;'>"i -;' "./
I, the undersigned, agree that any construction, reconstruction, enlargement, u:J.~~, ,1~:,I\1ter~m€~Jru'!1 ~,or any change in the use oHan.d. or st~ctures
requested by this application will comply with, and confo6il""to, all applic';i e IU' ,t __' (9~'Thma~'4: l'2:oning Ordinance of Carmell~di.ana -1993" (Z~
289) and amendments, adopted under authority opC 36~7 et seq, GeneralA: 0 e State of In~~ ,and all Acts amendatory thereto.' I~L!rt~~! certify,that only
kitchen, bath, and floor drains are connected t the sanitary sewer. I further that the construction will not be used or occupied until a Certificate of
oS:tbee~;rbYt Dep entofco1 ~;:~S'-D~tiana vJOJ ~(I
Signature of OWner or Authorized Agent frint Dat
,
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53. :)'0
P.R.I.F.: / ;J C. / if() Additional Fees
~ ',&' .2 7S/f/O
Q7Y1)- . 3/6- ~ 'C;J
~ed by: Date
Filing Fees:
Base Inspections:
Cert. of Occupancy:
# Charged Re-
Reviews
CW-) 3 "'Z:1...~c>[
Reviewed/Ap royed: Dept. of Community Services (Date)
S:PermltsjFormsjIlP RESIDENTIAL