HomeMy WebLinkAbout07040217 Application
City ofCarmellClay Township 0 '10 4 o~e~j #:~
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:
NAME5;4t1o /
STREET ADDRESS: r 1/' ,
'3 z 9~- ~ ,'Ir jv'tJ,
BUIDRt-'46~?JJs @ /t(J( ~O~
5~,E
NAME:
STREET ADDRESS:
SEWER UTILITY r7' I . I
PROVIDER: C, ~ VlJ
SG:S/'NA~:; ke.r~
C~STRumON: '""1"->
~Q..<f ltIS'tD~ I (<::t ~
WATER lJTIUTY /7
PROVIDER: l-tiLY'rl-e. /
PHONE:
FAX: 5J~7J'- ~Olf
~tf.J~
S-? J -fOoD
STATE:
.Ilt/
BEST METHOD OF CONTACT: /)
;u 7-~ 77'-f;O(J Lel/.._
PHONE:
FAX:
CITY:
STATE:
ZIP:
SEmON:
CJ2-
ZONING'flU.Jj
SQUARE
FOOTAGE:
3)3
ESTIMATED COST OF CQNSTRUcnON:
(EXCLUDING LAND VALUE) / ,;{ cJ. cf?/"7. tr?J
g~~
NAME OF UTILITY EXCAVATION CONTRACTOR; PLA.N COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); ANDIOR COUNTY WELL AND/OR SEPTIC PERMIT #'5 (IF APPUCABLE):
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY:
TYPE OF CONSTRUCTION:
o SINGLE FAMILY
~ TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions. Remodels. Etc.)
FOUNDATION TYPE: (Check all that apply Iqr the new
construction area) C~~O\"tll
o CRAWLSPACE 6~~'&iS~~~ _PIER
PL SLA o~~,~i~~ ~~T: S-N)
For Single Family and Two Family dwellings. additions, remodels, and/or accessory structurdf\.~ ~iS. r ~~~\~i~ii'r.~ia t' ISO
days of the date of issuance of the building permit, and must be completed (Certificate of oc~~ss*<<9\iitth~,~~~~ of...t.lte~ce date. Class I
structure pennits are subject to the General Administrative Rules of the State of Indiana (See 615 IAC 12)'te~~f*~rraq~trames for beginning and
completingconsITuction. _cQ\ O~ F\.~~. \..1 ...._,,\~
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alteration ~>t"t!.e~yc . }ffieuse of land or structures
requested by this . tion will comply with, and conform to, all applicable laws of the State of Indi~~ ~~Zoning 0 n nce of Carmel Indiana -1993ft (Z~
289) and am ent dopte er authori .c. 36~7 eq, General Assembly of the State of InUib\th, and all Acts amendatory thereto. 1 further certify that only
kitchen, h d or . s conn e sanit sewer. I further certify that the construction will not be used or occupied until a Certificate of
Occu enra!C ervim,c70t;~ f! 6o.-rhdc:J
S Print
Early Release
Permit:
PROJECT INFORMATION:
Lot Split:
_Y~
_YAN
TYPE OF IMPROVEMENT:_________PlUMBING CONTRAlIT6'1i: APR 2 3 2007
,::IiO.- NEW STRUCTURE<:;I7O(~ a;#.'J \!:
o ROOM ADDITION(S) Plumber's Indiana State License #:~
g ~~~~~~~~~~\S) R8 '10 / q_tt2___~
o REMODEL
_ Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION
Manufactured
Trusses:
~Y_N
_Y~N
Sump Pump:
OFFICE USE ONLY: ***************************** *~***~***.********* * ****)*~3***~O** ***************
INSPECTIONS REQUIRED: FIling ees. {;l d- ' -
. . Base Inspections: ~3- if. ~
pper Foo~rng Lower Footrng Under Slab s)---; r- rJ
Cert. of Occupancy: .::> '
Site-----; I-l G! 00
P.R.I.F.: V'
$ ;02?1 311
<;;-"2- 07
(Date)
Dept. of Community Services
S:Permltsjforms/ILP RESIDENTIAL
-----';--:
. ....-~" r-;:-= /~~., I' '<
i ..
'I'
, ,
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\ ., \ "- ~ ,
TAX MAP PARCEL #:- ~~ -
f.r ,Iii
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Which plumbing codes will be applied to the construction:
l}( International Residential Code wjIndiana Amendments
o Uniform Plumbing Code wjlndiana Amendments
.:./-071-0/
Date
# Charged Re-
ReViews
Additional Fees
TOTAL:
Fee Received by:
Date