HomeMy WebLinkAbout07050219 Application
City of Carmel/Clay Township Permit #: o7o~t9
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER NAME: E:sr(2 \\'":>.( C (J.J ;, -ro M PHONE: ~5>-8530 FAX: 8!:>-2511...
OF
RECORD: STREET ADDRESS: CI1Y: STATE: ,,,,, ZIP: 4<.031-
14!o'" CLA'( -rt--(I(JA <-<:. <!.c" i> ~;E" uro <:.A.(l...M.€L.
BUILDER'S EMAIl ADDRESS: BEST METliOO OF CONTAcr:
o...,e"",e <U+r;J'I'!-. "'ll.t e.-M4>-~ \
PROPERTY NAME: PHONE: FAX:
OWNER: ~<:
STREET ADDRESS: CI1Y: STATE: ZIP:
LOCATION LOT #: SUBDMSION NAME: SEmON: ZONING:
& PROJECT 5Ji'> V'LLA4c ~ 1,./.0-,., c,,^y fJi;:>
INFO: ADDRESS OF CONSTRumON: SQUARE 1->51
13010 f)CE"f.S"t't,.)~ /..e.E&J .>T, FOOTAGE:
SEWER UTIUTY <......A'i WATER UTIUTY ESTIMATED COST OF CONSTRUcnON: .f
PROVIDER: PROVIDER: (A(l.MCL (EXCLUDING LAND VALUE) 541.,.~;:'
NAME OF UTIUTY EXCAVATION CONTRAcrOR; PLAN COMMISSION I BZA I BPW DOCKET (l:1 ,""o~U
NUMBERS; TAC OATE(S); AND/OR COUNlY WELL AND/OR SEPTIC PERMn:."S (IF APPUCABLE):
FLOOD ZONE AREA DESIGNATION(S) -41fO'TD50J.~ I TAXMAPPARCEL#:
FOR THIS PROPERTY:
TYPE OF CONSTRUCTION:
A SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIOENTIAL (For
Additions. Remodels. Etc.)
PROJECT INFORMATION:
Early Release
Permit:
Lot Split:
_VLN
_VLN
TYPE OF IMPROVEMENT:
~NEW STRUCTURE
o ROOM AODITION(S)
o PORCH ADDmON(S)
o DECK ADDmON(S)
o REMODEL
_ Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION
Manufactured
Trusses:
Sump Pump:
LV_N
LV_N
PLUMBING CONTRACTOR:
f!. T }.A<x>~
Plumbers Indiana State License #:
(0052...0
Which plumbing codes will be applied to the construction:
9 International Residential Code w IIndian~mendments
o Unifonn Plumbing Code wI Indiana e1<\~~nts
rb~A~
FOUNDATION TYPE: (Checl<dffl~PPly~e~
construction area) O~- ~ ~o~. N~ ~~"
o CRAWLSPA~~ ~ '*~'~~~ _PIER
o SLAB ~~l'R~~ LVLN)
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, ~.s ~~ ,f'.-o1td.~'@ . st~: ~~ences within 180
days of the date of issuance of the building pennit, and must be completed (Certificate of Dccu ~n ) ~~~ .,h~t~ Issuance da~e. ~lass I
structure permits are subject to the General Administrative Rules of the State of Indiana (See 675 reg~~eXE:~~ ames for begmmng and
completing construction. (\. ('.Y' "
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alteration of a struc~or~ cnange in the use of land or structures
requested by this application will comply with, and conform to, all applicable laws of the State of Indiana, and t~" Ibtg- Ordinance of Cannel Indiana - 199J" (Z'
289) and amendments, adopted underauthoricy of I.c. 36-7 et seq, General Assembly of the State of Indiana, an cts amendatory thereto. 1 further certify that only
kitchen, bath, and floor drains are connected to the sanitary sewer. I further certify that the construction will at be used or occupied until a Certificate of
~In issued by tbe Department of Community serviC"~~ I::..:s sf, ./.t
Signature of OWner or Authorized Agent Print Date I ,
OFFICE USE ONLY: ****** ********* * ***** *********~~******************* **1 **9r*;.;0*****************
INSPECTIONS REQUIRED: Filing Fees: ! { J 0
~ ~ ~ Base Inspections: ;:;;-<f 7. $I
~er Foot. L er Footing Under Slab S:i :)'0
_ ~ 2r -y Cert of Occupancy: .
'" -,...., """., - ~(IO ...
P.R.I.F.: . Additional Fees
r~\, ~/ J 5...>-..f 5 /3 J-::!!7/ ,~02 7' 3. 70
ReVieWedIAP"':JvJtept. o(Community Services (Date) ~
S:PermltsjForms!ILP RESIDENTIAL
Fee Received by:
# Charged Re-
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