HomeMy WebLinkAbout07040047 Application
F-cmut)/ft/ r!ft-1I-55 i:J~YS CJJ/f.)l$ BC/571AJG t:?hP }l
City of Carmel/Clay T%:,ffj,~ Permit #:D'7D1 00 ~ 7
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, &. Two Family: New Structures, Additions, Remodels, &. Accessory Stru~ures
Sh 'j 62-</3
CITY'oHuB-
t-JYL-rn
PI::
For Single Family and Two Family dwellings. additions, remodels, and/or accessory structures, this pe~~~_~_ _ -", t~~~~~i~~ if "n 180
days of the date of issuance of the building permit, and must be completed (Certificate of occup~~~),'i."\\~ ~61~.~\1,.'f\~V~~C ate. Class I
structure permits are subject to the General Administrative Rules of the State of Indiana (See 675 IA'tS~ ~Qh\lfm, ~s~ for beginning and
completingconstnlction. . A-<(, ~-;"f\~\"'N~
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alteration of a structu~~I'1r.~ ~W~.t[~~~)and or structures
requested by this application will comply with, and conform tQ7all.applicable laws of the State of Indiana, and,ttTh~n:' " t;;nce ~Yrffiel Indiana - 1993" (2-
289) and amendments, adopted under authority of I.e. 36~7 et seq, Gener~l Assembly of the State of Indiana, anrJ:",\1('Att endatory thereto. I further certify that only
kitchen, bath, and floor drains are connected to thlsanitary sewer. I further...certify that the construction wib'bl be used or,occupied until a Certificate of
Occupancy has been. ,ned by the Departmentf cq=r . y Seevices, C d, fndiana. fit/;7
Signature of Owner or Au "zed Agent \ '0 p on Date
OFFICE USE ONLY: *************J******** ~~**)ect*'**********************7********~l'***************
~\- . (]/Filing Fees: _ ~ ?f/ J ()
INSPECTIONS REQUIRE . / ()
. . . Base Inspections: II ,[;. d # Charged Re.
Upper Footing Lower Footing Under Slab ' --- :---0' Reviews
~ Cfi.~ Y Cert. of Occupancy: , ~ 2>. j
\...RO~ Meter Base Final Site
P.R.I.F.: Additional Fees
BUILDER
OF
RECORD:
NAME:L ,_T S'rvrvt;; G. we
PROPERTY
OWNER:
STREET ADDRESS:
/2-'1zlJ
LOCATION LOT#: ~~
lit PROJECT il J
INFO: AD~q!TUCT1 \:0. ttl'=
SEWER UTILfTY WATER UTI~ /7
PROVIDER: PROVIDERG'~
NAME OF UTlLl1Y EXCAVATION CONTRACroR; PLAN COMMISSION i BZA i BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WEll AND/OR SEPTIC PERMIT #'S (IF APPLICABLE):
TYPE OF CONSTRU
(2{ SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
.0 RESIDENTIAL (For
Additions, Remodels. Etc.)
o NEW STRUCTURE
o ROOM ADDITION(S)
o PORCH ADDmON(S)
o DECK ADDmON(S)
IB'" REMODEL
_ Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION
PROJECT INFORMATION:
Early Release c/' Manufactured
Permit: Y =-N ~Trusses:
Lot Split: V i.-ff Sump Pump:
_v/
v~
0..-'
Reviewedl Ap : Dept. of Community Services
S:Permits/Forms/lLP RESIDENTIAL
FAX:
STATLr
BEST METHOD OF CONTACT:
lIP:
50Lf
PHONE:
FAX:
STATE:
:{1J
~ (003)3
SEcnON:
ZONING:
-I
/IRY
SQUARE
FOOTAGE:
ESTIMATED COST OF CONSTRUcnON:
(EXCLUDING LANO VALUE) /2-. 1m
~"" 1"--.- ,I
TAX' MAP PARCEL #:
! i r- o_~
/.11
),)
i'-_" I "
PLUMBING,~O,~!RA~:_ 9 2007Vi I'!
f I I ! I ~ I ~ J I,
'II Ii: Iii dl
Plumber's I?diaiia,StateUcense~.:..____.J ,-; I
, I
I i
- --'~._--"--'^----_.... ,____^___ .J
Which plumbing codes will be applied to the construction:
I
o International Residential Code w/Indiana Amendments
o Uniform Plumbing Code w/lndiana Amendments
FOUNDATION TYPE:
construction area)
o CRAWLSPACE
~D
TOTAL:
f7; Or {JO
Fee Received by:
Date