HomeMy WebLinkAbout07050145 Application
City ofCarmellClay Township Permit #: 07f)t=)"()/LP5
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER
OF
RECORD:
NAME: -rLA-Pf Shed
PHONE:
FAX' I
3 (7- 7 7t(~L 7-
ZIotO!
PROPERTY
OWNER:
LOCATION
& PROJECT
INFO:
SEWER UTILITY
PROVIDER:
17-77'f-21i1
/'1 >;7;, I
e.:>u',ie.- IV
BEST METHOD OF CONTACT:
hone-
FAX:
f.
PHONE:
3i7-?7 -P:t{) 317-9/3-1; g3
CtJ.r~~ ( 7?iTE:
.5
(llAfrM::.J :rill
L(6tJ33
ZIP:
L/t033
5:::<'
SQUARE /
FOOTAGE:
SECTION:
ZONING:
WATER UTIliTY
PROVIDER:
ESTIMATED COST OF CONSTRumON: '~ <700
(EXCLUDING LAND VALUE) V ( 0
EXCAVATION CONTRACTOR; PLAN COMMISSION I BZA / BPW DOCKET
TE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'5 (IF APPLICABLE):
~:
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY:
TYPE OF CONSTRUCTION:
o SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
b( RESIOENTIAL (For
~ Additions. Remodels. Etc.)
PROJECT INFORMATION:
Early Release
Permit:
-~~
Lot Split:
5' ature of Owner or Authorized A
~UMS
TYPE OF IMPROVEMENT:
o NEW STRUCTURE
o ROOM ADOITION(S)
o PORCH AODITION(S)
o DECK AODmON(S)
o REMODEL
_ Basement Finish only
~ ACCESSORY BUILDING
/'0 DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION
PLUMBING CONTRACTOR:
~~ Indiana State License #:
Which plumbing codes will be applied to the construction:
..,9:Intemational Residential Code w/lndiana Amendments
/~niform Plumbing Code wI Indiana Amendments
Manufactured
Trusses:
Sump Pump:
.---
_Y_N
Y~N
/;- tb-2007
Date
************************************************************
91~o
5-15'0 .
~s-50
OFFICE USE ONLY: ********************
Filing Fees:
INSPECTIONS REQUIRED:
Upper Footing
Base Inspections:
# Charged Re.
Reviews
Rough In
Lower Footing Under Slab
Meter Base ~~
Cert. of Occupancy:
P.R.LF.:
Additional Fees
;f?vO.~d .
c1B. ,~M
Date
'-Z'Z~07
(Date)
'J) :TOTAL:
--YCif'fY'v~
Fee Received by: ..
S:PermitsjFormS/ILP RESIDENTIAL