HomeMy WebLinkAbout07050148 Application
City of Carmel/Clay Township Permit #:()7b50/4i
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER of
RECORD:
STATE
NAME
~
PHONE 3
'Of ~
I
BUILDER'S EMAIL ADDRESS
PROPERTY
OWNER:
NAME
SMG
PHONE
STREET ADDRESS
CITY
STATE
LOCATION
&. PROJECT
INFO:
LOT #
II
E
I3E/J
WATER UTILITY
PROVIDER: C1-t tl1 G L-
I
GNItJC:
5-/
SQUARE 7/3D
FOOTAGE: CO
SEWER lJTILITY
PROVIDER: C LA- Y
ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE)
t'&olJfJ(J!!!
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION ISZA I BPW DOCKET
NUMBERS; TAC DATE{S); AND/OR COUNTY WELL AND/OR SEPTIC PER.MIT #'5 (IF APPLICABLE):
G
TYPE OF CONSTRUCTION:
1ll SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units:
o MULTI-FAMILY
# of Units:
o RESIDENTIAL (For
Additions, Remodels, Etc.)
~
o
o
o
o
o
o
'Jff d-tJ (,07017(;,
PLUMBIN CONTRACTOR:
/<'k;o.'ii/t=/L ~tJp6 5
Plumber's Indiana State LIcense #:
C-~9htJ()CJf
Which plumbing codes will be applied to the construction:
~ International Residential Code wjlndiana Amendments
o Unifonn Plumbing Code wI Indiana Amendments
(Multi-Family Construction Code)
PROJECT INFORMATION:
Early Release
Permit:
FOUNDATION TYPE: (Check all that apply for the new
construction area)
Manufactured
_Y ~N Trusses: _Y ~N
"'Y _N 0 CRAWLSPACE 0 POST & BEM1
Lot Split: _Y LN Sump Pump: ~ 0 SLAB PO BASE X~:y
Does any part of the property lie within a special Flood designation area: Y LN 'i~ Y N
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this permit i~n~\l~~st~1d; ~ences
within 180 days of the date of issuance of the building permit, and must be completed (Certificate of ?^~IY.ti~~~~~~\tof the
issuance date. Class I structure permits are subject to the General Administrative Rules of the s~ate f ~!lDt\.~ee~'1'1\~\~1ig expiration
time frames for beginning and completing constr . R\W~n-~~". ~ ""-O,,.J
I, the undersigned. agree that any construction, rcconstruction. enlargemcnt, relocation, or altem . a ~~W'~;;~ thc use of land or
structures requested by this appLIcatIon \viJJ campI}' with, and conform to, all.1ppJjcabJe law . S~t\Plif~~R~thft.~~~,Ordinance of Carmel
Indiana - 1993''' (Z-289) and amendments, adopted under authority of l.c. 36~7 ct seq, Genera ~~'1y df)t~f;,:~O ~. In '~lliActs amendatory
thereto. I further certify that only kitchen, bath, and floor d~..are--s-onnccted to the sanitary _ vcr. I f ~ c ~h~ construction will not be
used or occuPie~~~c t~ of Occupancy h JOeen issued ~e~~m~t o)(~m $::<,' c~ ,Indiana. . //7 If) 7
of Owner 0' Authorized .,int o!6 /
OFFICE USE ONLY: **********
INSPECTIONS REQUI
~~rFoo~
~U9h 1;) <Eet;'-~ Final
# Charged Re-
Reviews
Site
P.R,I.F,:
Additional Fees
1',2f, 50
~ ~-2~-o7
ReviewedjAppr ed: Dept. of Community Services (Date)
S:Permits/Forms/ILP RESIDENTIAL
c
Fee Received by: