HomeMy WebLinkAbout07040137 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: .
bre
STREET ADDRESS:
'021 -Pf\
BUILDER'S EMAIL ADDRESS:
sad \ rLf8:5
NAME: ~
STREET ADDRESS:
5,S-GlI-rn
FAX:
6J (LO\ . lam BEST80':\'Y-\ONTAcr:
-m\..J
..-"
SUBDIVISION NAME:
PHONE:
FAX:
CITY:
STATE:
ZIP:
ZONING:
S
\
\
tour-\-
\ I V> o.J.c, ESTIMATED COST OF CONST~ClJlI..N:
\LU ~'-- (EXCLUDING LAND VALUE) ::j, em CYCf:)
~t-\ G';~Q (p~t:;-
0/2
SQUARE
FOOTAGE:
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA I BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNlY WELL AND/OR SEPTIC PERMIT #'5 (IF APPLICABLE):
fLOOD ZONE AREA DESIGNATION(S).
FOR THIS PROPERTY:
..(\5).
TAX MAP PARCEL It: ! Ii: \
!"iF, 'il 11\
PLUMBING CON~i~~~o~PH 1 8 LU I "ll})' \
Eds A~r \CeC_-J_J
Plumber's Indiana\State"Ucense #: --J" i
~ UU.c ~-~;P-IDt.-6D0-r'5J
TYPE OF CONSTRUCTION:
~ SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions. Remodels. Etc.)
TYPE OF IMPROVEMENT:
.p< NEW STRUCTURE
o ROOM ADDITION(S)
o PORCH ADDmON(S)
o DECK ADDmON(S)
o REMODEL
_ Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOUTION
OFFICEUSEONLY:******************************~~*************************1**( 0*******************
INSPECTIONS REQUIRED: Filing Fees: ;;r
Base Inspections: J 1/) ( 00
~ /' /0
Cert, of Occupancy: h '),)
P'~I.F' . /J-bUO
TOTAL:// i J ~S-O. 30
~KJ--/~
, $- \-07
ept. of Community Services (Date)
S;Permits/FormS/ILP RESIDENTIAL
Which plumbing codes will be applied to the construction:
J2I International Residential Code w IIndiana Amendments
o Uniform Plumbing Code w/Indiana Amendments
# Charged Re-
Reviews
Additional Fees
Fee Received by;
Date