HomeMy WebLinkAbout07050166 Application
City of Carmel/Clay Township Permit #/)7IJ5D Ibfa
J RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
FAX:'3i7 'i?lf6-1'97
NAME: c...e.GC:. MA ~"/f.J
~O(l) ('Olf..! We,.
PHONE 3{7 372 '1'2.17
BUILDER
OF
RECORD:
>rATE: I N ZIP: 1'2<;0
P/tONl::-
7 72.-
'7
CITY'
1i-'I1N5
STREET ADDRESS:
:;'0 <2 c~-nTO/V.() R-.
BUILDER'S EMAIl ADDRESS: c>
L€/?-IJ/I1. P '.29~1 ~ Y.,P.NCO
NAME:7om e KA-rHY CAL/iOVN
,
BEST METHOD OF CONTACT:
,eOM
7
FAX:
PHONEjq 'iN/.{ -9 Z 7Z
PROPERTY
OWNER:
.STATE:
'JJ
Cl1Y:
~#/!Jf1t=L
STREET ADDRESS:
S-,,~ cPOOf)F"!L:'Zl
LOT#/c" ~
ZONING: .s ..
SECTION:
713
;;t..J
SUBDMSION NAME:
fAJtyO(J FIE"LIJ
LOCATION
& PROJECT
INFO:
SQUARE .
FOOTAGE: 200
ADDRESS OF CQNSTRUcrrON:
S.5'Ofl vloolJFIe-LI) w.4
WATER lJTIlfTY ESTIMATED COST OF CQNSTRUCTIO
PROVIDER: c412/J4t;l. ur1uT/c1 (EXCLUDING LAND VALUE) -21 FjtJO
SEWER UTILITY
PROVIDER:
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION I aZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR (CUNlY WELL AND/OR SEPTIC PERMIT #'5 (IF APPLICABLE):
TAX MAP PARCEL #:
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERlY:
TYPE OF IMPROVEMENT:
o NEW STRUCTURE
~ ROOM ADDITION(S)
o PORCH ADDmON(S)
o DECK ADDmON(S)
o REMODEL
_ Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOUTION
TYPE OF CONSTRUCTION:
o SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
RESIDENTIAL (For
Additions. Remodels. Etc.)
s Indiana State License #:
Which plumbing codes will be applied to the construction:
o International Residential Code w!Indiana Amendments
~
OFFICE USE ONLY: ********* ****************** * * **.~*****************~***i!J* * * * *~ *********** * ******
INSPECTIONS REQUIRED: Filing Fees: ,lb-eX. ) V
Ai ~. Base Inspections: / ~,). -')0 # Charged Re-
<:pper FootIn Lower FootIng Under Slab ' ,.. ~ ReViews
~. Cert, of Occupancy: ,.,-.). ,)0
Rough In Meter Base <tInal S~
P,R.I.F.: ~O/TA~L.. . -;:;b':3 J'il, ~nal Fees
r~ "Cvo--\~I1I~'" ~/n~Vl ~ _-~
Reviewed/Approved: Dept. of C mmunity Services (Dale) .' ",
S:Permits!FormS/ILP RESIDEI'nlAL Fee Recelv by' Date
~