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:
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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:
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BEST METHOD OF CONTACT:
FAX:
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d' 'i?~~
ZIP:
t.-{G,-;;SO
STREET ADDRESS: em:
("L.tolc> 13-- '7$-lb ~-\. -4c"<> - ~
STATE:
l,:,:> ' .-:::oJ ,
LOT~
SUBDIVISION NAM~:
SECTION:
ZONING:
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--
,
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~~
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