HomeMy WebLinkAbout07050178 Application
City of Carmel/Clay Township Permit #:07n50/7f}
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:
NAME:
CITY:
STATE:
I
ZIP:
I
BEST METHOD OF CONTACT:
PHONE:
FAX:
STATE:
I
ZIP:
'J.7f?
SECTION:
3
ZONING:
$-
ESTIMATED COST OF CON5J1umON:
(EXCLUDING LAND VALUE) P
SQUARE
FOOTAGE: 5
07050/17
SEWER UTIliTY WATER UTILITY
PROVlDERC PROVIDER: C
NAME OF UTIlITY EXCAVATION CONTRACTOR; PLAN COMMISSIDN / BZA / BPW DOCKET
NUMBERS; TAC DAlE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPUCABLE):
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY:
\, \\,
:".,\\ \, \\
TYPE..OF CONSTRUCTION: , ;--:>fYpf' FIIMPROVEMENT:
M' SINGLEFAMII,)' ,/ 1,) ~~~j~RUCTURE
o TOWN HOME \ 'l.\l R 0111 ADDITION(S)
o TWO FAM~~~Y\ . ....\<< 'l.. 0 P RCH ADDITION(S)
# of umtsbemw,l' DECK ADQITION(S)
constructe'lat this 0 REMooEl
time: \\\ \ \ \ ~ Basement Finish only
o RESIDENTIAL '(For 0 ACCESSORY BUILDING
Additions. 'Remodels.y.w, 0 DETACHED GARAGE
'\..-._______ 0 ATTACHED GARAGE
PROJECT INFORMATION: 0 DEMOUTION
yV;:
y;?r;
Early Release
Permit:
Lot Split:
Manufactured
Trusses:
~'y_N
~Y_N
TAX MAP PARCEL #:
PLUMBING CONTlV.CTOR:'"
_PAu.l E. SMin'" ,
Plumber's Indiana State License #:
10/777
Wh9 plumbing codes will be applied to the construction:
M International Residential Code w/lndiana Amendments
o Uniform Plumbing Code w/Indiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area)
o CRAWLSPACE 0
o SLAB ~SE
POST & BEAM PIER
Ow",LKOUT:_Y ~
Sump Pump:
For Smgle FamIly and Two FamIly dwelhngs, addItiOns, remodels, and/or accessory structures, this permit l~~~ \ X ~#ftrUctlOn commences WIthm 180
days of the date of Issuance of the buildmg pemut, and must be completed (CertIficate of Occup~~~tjlij,~O\IB !!lQnths ~ssuance date Class I
structure pemuts are subject to the General AdministratIve Rules of the State of Indiana (See ~~.n) t~~n~~i?a~l~~~~ for begmnmg and
completmgconstru:;"IR~\1\,1 f""'.l\\~}\V O~}li-\ e.~'(\ t:lS'(\\.~
I, the underSigned, agree that any constructIon, reconstructlOn, enlargement, reloca~~~l\r~l')f:lO\l:,Qba'9tra~~;o,~an~ e~ \.ise of land or structures
requested by thIS apphcatIOn wdl comply wIth, and conform to, all apphcable laws ot",&:.&~g.~'lRd~,&\iAd=t~~~..&. q;plnance of Carmel IndIana -1993n (Z~
289) and amendments, adopted underauthorlty of I C 36-7 et seq, General Assembly o~~te otfn81aljl-a.'@1\il~ll Ac~~"""'CGtory thereto I further certify that only
kitchen, bath, and floor drams are connected to the sanrtary sewer I further certify that the cOl},~t~o'w'~n~lJ..e w~iJr occupied untIl a Certificate of
Dc upancyhas been Issued by the Department of Commuruty SelVlces, Cannel, IndJanaac.?-\ C",~\'1'~~\i^
. S" \:w n'<: r' \\~v .1
. - lOR; fl. B;1I.~,crt;.-H611l1;tJt 5/17107
Signature of Owner or Authorized Print V Date
OFFICE USE ONLY: ******************************~~****** **************iZ'?{!)******* ****************
INSPECTIONS REQUIRED: FIling Fees: , ~ r;;L. G~
r ~~otm~er ~nder Slab Base Inspections: C;J (17 J tJ
.' Cert. of Occupancy: sS-: ()
/~ 6) (JO
Final
Site
P.R.I.F.:
# Charged Re.
ReVIews
Additional Fees
t'.
S;Permits/formS/IlP RESIDENTIAL
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