HomeMy WebLinkAbout07050069 Application
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City of Carmel/Clay Township Permit #: t5 7 fJ0cXX4/
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:
NAME~
N
Gu_..l OTT
II\.lL
PHONE:
e>4-'I - q l1>&
FAX:
8~ -'12G._D
BUILDER'S EMAIL ADDRESS:
~ f0 A- 10 ~LL..i <:fIT
NAME:
CITY:
STATE:
1\'0
ZIP:
4(..2..;~ D
BEST METHOD OF CONTACT:
CeLL...: '5" ,- 40
1II1aS ~
PHONE:
FAX:
-e
LoPU
LAS'.;
CITY:
~mlEL.
STATE:
110
ZIP:
4'-0"3
STREET ADDRESS:
1-7 :t LV.
\-st-
LOT #:
SUBDIVISION NAME:
ADDRESS OF CONSTRUCTION:
'2--""1"2--1 W. I~\ <t,+
WATER UTIUTY
PROVIDER: 7
SECTION:
SQUARE
FOOTAGE:
-WI). "
(-7 tl
ESTIMATED COST OF CONSTRUcrrON;
(EXCLUDINGlANDVALUoj 2.t&J0 00 i)
"
J
NAME OF UTILITY EXCAVA ON CONTRACTOR; PLAN COMMISSION / aZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'5 (IF APPLICABLE):
FLOOD ZONE AREA DESIGNATlON(S)
FOR THIS PROPERlY:
TYPE OF CONSTRUCTIO
SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
/time:
iY RESIDENTIAL (For
Additions. Remodels. Etc.)
TYPE OF IMPROVEMENT:
o NEW STRUCTURE
~OOM ADDITION(S)
o PORCH ADDITION(S)
o .;DECK AODITION(S)
gr REMODEL
_ Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION
t{~
~
TAX MAP PARCEL #:
PLUMBING CONTRACTOR:
-!-\,l.-M ~ ~ "bo &'->S"
Plumber's Indiana State License #:
I OOC>O \ 01
Which plumbing codes will be applied to the construction:
;6 International Residential Code wI Indiana Amendments
o Uniform Plumbing Code w/Indiana Amendments
Early Release
Permit:
PROJECT INFORMATION:
Lot Split:
_y--.KN
_y~N
Manufactured
Trusses:
Sump Pump:
_yJ(N
~y_N
INSPECTIONS-R~ RED:
<:!!pper Foofini;> Lower Footing Under Slab
~ Meter Base ~
******************************~************************
Filing Fees: ,;L i!/r;.,] 0
7:1 1)
/, i
, ;.;.
-SS: :50
Base Inspections:
# Charged Re-
Reviews
P.R.I.F.:
Cert. of Occupancy:
Additional Fees
S;Permlts/FormS/ILP RESIDENTIAL
-fltl. 30
Date