HomeMy WebLinkAbout07030207 Application
City of Carmel/Clay Township Permit #: 0 71J.~7
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:
NAME:
S { I ~ tr --/A1I ( I-1.C
STREET ADDRESS:
sf
FAX:
8Y-,J-St?f.>,f
/ /) STATE:
ZIP:
tf"'~~{J
7 5"" ""- sf
SEWER UTILITY
PROVIDER: {/( IlIiJ D
lOT #:f) ;;UBDMSION NAME:
qO AIO-e'r h
ADDRESS OF CONSTR~ON:
D f:)r-/~h,ck:.
WATER l1TlUTY
PROVIDER: (4 r t>.-e I
FAX:
~p I,;;1,,7
cm:
STATE:
/7
ZIP:
'I0~
/11
SECTION:
ZONING:
5-(
SQUARE
FOOTAGE:
5'of<(
ESTIMATED COST OPCONSTRUCTION' ,,--..---..- ._.__~u.
(EXCLUDING LAND VACU!'ll,=~ ~_.~ ' c ~ nJ \';./0' "-~ Ie;:> .
~ ; ~ I I '.. - . \.:1J (h v.~ i \, j
NAME OF l1TlLm EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET 0 I II 'I' 'I'
NUMBERS; TAC DATE(S); AND/OR COUNT\' WELL AND/OR SEPTIC PERMIT "S (IF APPLICABLE): IV { S 6/1 ()J ~ , ~', I E-- ;:'1 . i i
TAX MAP PAftttl 'lW'
PLUMBING CONTRACTOR: I
J If) 6,WQ..vto(;S
Plumber's Indiana State License #:
% lol.'l-~<..fO
FLOOD ZONE AREA DESIGNATION(S)
FOR nus PROPERTY:
TYPE OF IMPROVEME T:
F CONSTRU
SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions, Remodels, Etc,l
NEW STRUCTURE
o ROOM ADDmON(S)
o PORCH ADDmON(S)
o DECK ADDITION(S)
o REMODEL
_ Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION
Early Release
Permit:
PROJECT INFORMATION:
-::/'
Y N
Y ::1(
Manufactured
Trusses:
Sump Pump:
~N
~=N
Lot Split:
Whic,lumblng codes will be applied to the construction: '
CJ?I:ntemational Residential Code wI Indiana Amendments
o Uniform Plumbing Code wI Indiana Amendments
FOUNDATION TYPE: (Che,~~1l\t apply for th~ new
construction area) ~~~;-;'1.
o CRAW~ e\~Q$OST & BEAM _PIER
~~I'~~ ~~~ Y vN)
For Single Family and Two Family dwellings, additions, remodels, and/or accesso~'i es\~~.t1<Z~!_i~.:~~Q: Ion commences within 180
days of the date of issuance of the building pennit, and must be completed (Certifie ~u . ~ths of the issuance date. ,Class I
structute permits ate subject to the Genetal Adminis"ative Rules of the State of IndEiM~ee 6~ 'e~,,'C.nII p.~tion time &ames fot beginning and
completmgconstructlOn. ;"'( O,_",-~~", ~t)..~
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or a~)n o~ ~ure, ~ ~hange in the use of land or structures
requested by this application will comply with, and conform to, all applicable laws of the Stat 0 al': and the ~Zoning Ordinance of Cannel Indiana - 1993" (Z~
289) and amendments, adopted under authority of LC. 36'7 et seq, General Assembly of the Se\ f ndiana, and all Acts amendatory thereto. 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 used or occupied until a Certificate of
OC0~hasbe~;J::tmentofCommurntYSmicC:~~'ln~O~ . 107
Sl.na,""of~"'AUth""""'..ent Print j ~,
OFFICE USE ONLY: ********************************************************.
Filing Fees:
Base Inspections:
Cert of Occupancy:
Upper Footing
c.
INSPECTI
EQUIRED:
Jab
---~---,
P.R.LF,:
,
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