HomeMy WebLinkAbout07050003 Application
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City of Carmel/Clay Township Permit #: 0706(')co3
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: 6
raJ;so,,",
Gu; /
'fA S'I- tI :5
STREET ADDRESS:
330 &'
BUILDER'S EMAIL ADDRESS:
J 114 rh i.50"l
NAME-
nc(\!,
STREET ADDRESS:
/ ;;< Zf;;;.
LOT': q Lt
1'<< J ,Sz,r) ,i7 I.
J Ivd
J-/&/9rrd L.
r
30-
51,:/- 75:[;D
STATE:
~A/
ZIP:
<7':- ;250
BEST METHOD OF CONTACT:
317- :';''1b/- 7.575 Y.:(~{
FAX:
STATE:
J:/t(
SECTION:G,
ZIP:
L/~3 :z.
ZONING:
~--
ESTIMATED COST OF CONSTj)UcnON:
(EXCLUDING LAND VALUE)<,f 'ifi:2 7/i/. aD
NAME OF UTIUTY EXCAVATION CONTRAGOR; PLAN COMMISSION / BZA / BPW DOCKET L ,.-
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE): U t"lc.{., e..oIJ5 ,Ir;;/J;, ~_~:~7r'~-r=~-';i- ,~. >7 :~ ~; ~.,:\.
..;T Ax MAP PARCEL #:; )!:='.'...2:2: ''.:O:-'--'-'-~~=-lll'-i[ \ 11/
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,i;<; I < I I .
PLUMBINGCONTRAdORl\.! i MAY - 1 2007 Iii ill
.j~i~ ill lJ.. il0l
Plumber's Indiana State License #: I
Jf1LfOD/::2 S(L I
SEWER UTILITY .
PROVIDER: 1.'Vd_J~.
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY:
TYPE OF CONSTRUCTION:
-1iIf SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions. Remodels. Etc.)
Early Release
Permit:
PROJECT INFORMATION:
/'
~ ~J
For Smgle Family and Two Family dwelhngs, arnhtlons, remodels, and/or accesso~tftictJres, '~s ;xahti construction commen s within 180
days of the date of Issuance of the bmldmg penmt, and must be completed (Certificate of (Xc' ,~~l.~w.~h~onths of the ISS e Class I
structure permits are subject to the General Admmistratlve Rules of the State of Indla{Il~~'67~_ ~..l)'r~~~x-piratlon tune fr 1. ing and
completmgconstruc'E':~, Qr ~-v-- ~~
I, the underSigned, agree that any constructIOn, reconstructton, enlargement, relocatIOn, oGha-ahon of a structure, or any chani ~ d or structures
requested by thiS applicatIOn wlll comply With, and c~orm.to, aWapplit;.abte laws of the State of IndIana, and the "Zonm . e rme! Indiana - 1993" (Z-
289) and amendments, adopted under authonty ojJ,e 36-7 et seq, General'Assembly of the State of IndIana, and all a ... ereto I further certify that only
kitchen, bath, and floor drains are connected to the sanitary sewer. I further 2ertify that the construction . , ccupied until a Certificate of
Occupanc has been issued by the Depar nto~o{.:tSTce'J~el'm;';biSO/7 ' . f-;J. 7-07
Signature of Owner or Authorized Agent I ~. Print Date
OFFICE USE ONLY: ********* *********t1*'t~I.*** .********************y*m'l'*~3****************
INSPECTIONS REQUIRED: - / ' Filing Fees: c:::x ~
r;';:u 'F~t' Base Inspections: / "l,.2 oS () # Charged Re-
,-,,~per ~~ Lower Footing . 0 Reviews
- Cert. of Occupancy: ---.IS- 5"
C Rouqh ~ Meter Base ~ar-
Lot Split:
WATER UTIUTY _
PROVIDER: Pc " V 4-1L
TYPE OF IMPROVEMENT:
o NEW STRUCTURE
'% ROOM ADDITION(S)
o PORCH ADDITION(S)
o DECK ADDITION(S)
o REMODEL
'_ Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION
Manufactured
Trusses:
Sump Pump:
J
_Y_N
_Y ---'..-N
Which plumbing codes will be applied to the construction:
Additional Fees
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P.R.I.F.:
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Reviewed/Ap rove: Dept. of Community Services
S:PermitsjFom1sjILP RESIDENTIAL
(Date)
Fee Received by:
Date