HomeMy WebLinkAbout07050223 Application
CityofCarmeI/Clay Township permit#:070S-0J:;J3
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER
Of
RECORD:
NAME:
STREET ADDRESS:
70r
BUILDER'S EMAIL ADDRESS:
...JA-E>
PHONE:
fAX:
ZIp.
~
STATE:
~
)....
BEST METHOD OF CONTACT:
PROPERTY
OWNER:
NAME:
PHONE:
FAX:
o International Residential Code w IIndiana Amendr:nents
o Uniform Plumbing Code w/Indiana Amendments I
I
. . '
. . FOUNDATION TYPE: (Check all that apply for the new
:t: construction area) '1
- 0 CRAW,I,S~~~E ~~0'1>~~~ BEAM ~PIER
o S ~l.~l~ALKOUT:~Y~N)
_>' J . __ .
For Single Family an.d Two Family dw~ll~ngs, add~tions, remodels, and/or accesso~y st~~~~~~~. .' -~_'" _.... s..oti~. ...i>' \~~ences wi~hin 180
days of the date of Issuance of the bmldmg pernut, and must be completed (Certl~~.C(~Z~. '~~lis~Qit~"",~ce date. Class I
structure pennits are subject to the General Administr~tive Rules of the State of In<U~~ 07~S\~' r .. ..!l"!."_~~.ii~'.w~~Q~e frames for beginning and
completingconsdi\ction. 0 00 t r"$. t.~~4',
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or:a1te . ~~st.r6.~~I;f1 ": in the use of land or structures
requested by thIS application will comply with, and conform to, all applicable laws of the S n3:lie~1t~~3: nance of Cannel Indiana - 1993" (2-
289) and amendments, adop under authority of I.C 36-7 et seq, General Assembly of the taNftUJliana, and al amendatory thereto. I further certify that only
kitche , a ,and floor dra s re connected to the sanitary sewer. I further certify that tG\~n~truction will not be used or occupied until a Certificate of
Dc .rpan has been issue b the Dep~ent ofConununity Services, Cannel, Indiana.
~l~ JH,\Al.-Vi5
Print
ICE USE ONLY: ********* ** ******** *******************************************~f ************* ***
INSPECTIONS REQUIRED: Filing Fees: ,/;2'9'15. cYO '
C- "~ : J _ Base Inspections: ~7/) II 6 # Charged Re-
'Upper Foot!D9"" wer Footl - 'r- ReViews
Cert. of Occupancy: .5). ~ tJ
~ )
P.R.I.F.: ') 1-./ dO Additional Fees
TOTAL: ,~ ff c2y{, (). 30
(
STREET ADDRESS:
LOCATION
&. PROJECT
INfO:
LOT #: C::Z9r
SUBDIVISION NAME:
1v/""Qs.o{L
WATER UTIUTY C'
PROVIDER: /J1 ~ -
N CONTRACTOR; PLAN COMMISSION I BZA I BPW DOCKET
NUMBERS; TAC DATE(S); A lOR COUNTY WELL AND/ORSEPTIC PERMIT #'S (IF APPLICABLE):
------::.~.+.... \
FLOOD ZONE AREA DESIGNATION(!;)~i vi. \ -,<<\).
FOR THIS PROPER1'I: "!.I \:?": \\1, ..
. \\\ \.
IU I"~
TYPE Of, IMPROVEMENT:
n1, III 11\
\) ~~ NIW;..5TI\UCTURE
:. 0 R~O~A ITION(S)
PORCH A mON(S)
DEC mON(S)
MODEL
_ Basement Finish only
ACCESSORY BUILDING
DETACHED GARAGE
ATTACHED GARAGE
DEMOLITION
SEWER U11UTY
PROVIDER: e
~
TYPE OF C
,
SINGL.
TOWN
o TWO FA
#ofu
constr
time:
o RESIDENT L (For
Additions. R m
PROJECT INFORMATION:
Early Release
Permit:
Manufactured
Trusses:
~Y~N
lL-Y_N
~YAN
~Y .lLN
Sump Pump:
Lot Split:
o
I
Dept. of Community Services
CTIY:
STATE:
ZIP:
~ .
ZONING:..s /
~g~~E: fIt vg
ESTlMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE) I DiY 0
eno SO;;J,3 L}-
to
PLUMBING CONTRACTOR:
JI~'v ci s,.......
Plumber's Indiana State License #:
Which plumbing codes will be applied to the construction:
--
.:J -;/l9.-O 7
Date
S:Permits/Forms/ILP RESIDENTIAL
Fee Received by:
Date