Loading...
HomeMy WebLinkAbout07050222 Application .- BUILDER OF RECORD: PROPERTY OWNER: LOCATION & PROJECT INFO: City of Carmel/Clay Township Permit #:.0 7050~~a.. RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures PHONE: FAX: v-.. \\~ STREET ADDRESS: LA.\J\... t;, ~ -::;-\lo 'S\.*'"<.f<:!:: STATE: :J::.\.J, ZIP: '-IVd.'56 em: BUILDER'S EMAIL ADDRESS: d(V) C:..cc.:Y\- 'OJ S, \V':..-\\-."'-'-h!. \-.CVV'\LS NAME: PHONE: ,\v e r-\-\"<>r~ BEST METHOD OF CONTACT: FAX: 'd-\'l;>'1~ d' 'i?~~ ZIP: t.-{G,-;;SO STREET ADDRESS: em: ("L.tolc> 13-- '7$-lb ~-\. -4c"<> - ~ STATE: l,:,:> ' .-:::oJ , LOT~ SUBDIVISION NAM~: SECTION: ZONING: ~- -- , \& \....0.. ~~ SQUARE S '1 -:-n). t{&,O/ FOOTAGE: ~ ESTIMATED COST OF CONSTRumON: " ~ (EXCLUDING LAND VALUE) clOS (L/I.-<-> SEWER UTILm 1'>-.--::-.. ~ PROVIDER: \....... " '\",,"-J~ NAME OF LfT1UTY EXCAVATION CONTRACT NUMBERS; TAC DATE(S); AND/OR COU " FLOOD ZONE AREA DESIGNATIONcs{1\ ''1', , FOR THIS PROPERTY: /'" <::::::l.\'~f' For Single Family and Two Family dwellings, additions, remodels, and/or accessory stru",&.LGA. t iSX!i~ c.Hpn commences within 180 days of the date of issuance of the building pennit, and must be completed (Certificate ~Q~t:pi~mrW1t' ~~rft}Q Me ilmate. Class I strUcture pennits are subject to the General Administrative Rules of the State of Indiana ~~e"'cff5 i~I9.~ ~XJl.irrt"'r S€'R'tJ e,.Wming and completing construction, ,...,c r,OM, u'" nWI\lSHlr I, the undersigned, agree chac any construction, reconstruction, enlargement, relocation, or alte~:rG ~ctMa.p.lj1 e~, cb.~~e1~1 rand. or structures requested by this application will comply with, and conform to, all applicable laws ofche State 0 . ". ,f.ZLM.,ftg"t)Mi e of Cannel Indiana -1993''' (Z- 289) and amendments, ado~ted under authority of r.c. 36-7 et seq, General Assem.bly of the St<G~ I d~F~1 Ac~~~~ereto. ! further .c:ttify that only kitchen, bath, and floor dn1lOS are connected to the samtary sewer. I further certify that the constructIOn will not be used or occupIed untIl a Certificate of Occup has be 'ssued e Department of Conununity Services, Cannel, Indiana, '": \"" U.~1 Zl-\l~ I ~ >!. Print o PROJECT INFORMA Early Release Permit: Lot Split: ~~ ~ ":X.v-.>e,,- TAX MAP PARCEL #: PLUMBING CONTRACTOR: ~\'b CD...... \..-c.~cV"<;. Plumber's Indiana State License #: <X\d.o L\";)tfo Whi~mbing codes will be applied to the construction: a(" International Residential Code wI Indiana Amendments o Uniform Plumbing Code wI Indiana Amendments _vd-N _VLN Manufactured Trusses: Sump Pump: FOUNDATION TYPE: (Check all that apply for the new construction area) "/v _N LV_N o CRAWLSPACE o o POST & BEAM ~PIER :'t~N V+N) , a ~~S-Ol Date OFFICEUSEONLY:****************************************************}*jr**:~*~******************* F'I' F . 7:L~ /0 INSPECTIONS REQUIRED: ling ees. - 7 j!' <iim> ~ ~ Base Inspections: ,;Jff7. )'0 er Footi L er Fo~ Under Slab 5) . 5'tJ r.....- ~~ Cert.ofOccupancy: ~ ~gh I~ter B~ @I S~ / J (, I 00 Additional Fees P.RJ.F.: ~ _ _ TOTAL: . ti/ /5J//./C # Charged Re- ReVIews S-U' ~5"'O-' : Dept. of Community SeNices (Date) \ S:Permi~/FormS/ILP RESIDENTIAL Fee Received by: Date