HomeMy WebLinkAbout07050172 Application
City of Carmel/Clay Township '. Permit #:~
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, 8< Two Family: New Structures, Additions, Remodels, 8< Accessory Structures
BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
8< PROJECT
INFO:
SEWER UTILITY
PROVIDER:
NAME:
STREET ADDRESS:
t./.. ivtt10
W~
PHONE: 30- '7?6-9939
FAX: '770 q:3~'1
BUILDER'S EMAIl ADDRESS:
NAME:
STREET ADDRESS:
LOH: 32
01Y:
STATE:
)t/
ZIP:
iI. 8' 2-
G'L
BEST METHOD OF CONTACf:
~?
PHONE:
.F'J/-
FAX:
ZIP:
'1,{.132-
STATE:
I,,{../
7
S-2--'
47
cm:
'f'L
SUBDIVISION NAME:
SECTION:
ADDRESS OF CONSffiUcrrON:
'(J 51 )rILL 1..."'-' C
CA)v.<"Z-
ZONING:
c
32-
SQUARE
FOOTAGE:
WATER UTILITY
PROVIDER: CNJ,hlJo L-
TYPE OF IMPROVEMENT:
o NEW STRUCTURE
ClY1l.00M ADDITION(S)
o PORCH ADDITION(S)
o DECK ADDITION(S)
o REMODEL
_ Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLmON
Manufactured
Trusses:
Sump Pump:
-yjL$
0~N
ESTIMATED COST OF CON~ON: _ _,_'
(EXCLUDING LAND VALUE) -- n~" ,h~\ "
o r:--" \ I. _ .("/1 CAV\\l!
'. ; \) Cc:~_':<..: ..::...:.... ;.
',::) [
,1,_-
" (
TAX MAP p~Rca!\~: MAY 2 1 20
!II I,!
l'~' "'., ____
PLUMBING CONTRACTOR:-;'-
~~4/r---' -- -..----
Plumber's Instf a tate License #:
I" ,
q ,
il\. III
\1: :,"
',1,1.\
k::J\
!
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION I BZA I BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPUCABLE):
~OO~Zqt~_~!.t\REf.~SIGNAT.lON(S)
R IS'PROPERn':
TYPE OF CONSTRU
w'SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
~ESIDENTIAL(For
Additions, Remodels. Etc.)
PROJECT INFORMATION:
For Single Family and Two Family dwellings, a.dditions, remodels, and/or accessory st ~s ~ . t....."'~)~'- ructian commences within 180
days of the date of issuance of the building permit, and must be'completed...JCertificate .; pa.nl'~~u !d~~~ hs of the issuance date. iClass I
structure pennits are subject to the General Administrative Rules of the St,aie'of lndian~ [See 675~~),l:F'-t;~~ ation time frames for beginriing and
/ completmg co trUctlOn. <,<::.",Y, "-.<;. \.J -~~
I, the undersigned. agree that any c?JlStruction, reconstruction, enlargement, relocatio ,or alteratilmJXJt ~cn:re, or any change in the use of land or structures
requested by this application will comply with, and conform to, all applicable laws of th State of I~~a~ and the ~Zoning Ordinance of Carrnellndiana - 1993" (Z-
289) and amendments. adoptedtnder authodty of Ie. 36.7 er "g. Gmer~1 A~bly 0 the State otYndiana. and all Acts amendatory thereto. I further mtify that only
kitchen, bath, and floor drain{ are connected to the sanitary sey.rer. I fur~ certify at the construction will not be used or occupied until a Certificate of
Occupancyh been iss.fd the DePrrt ~I ~O~Uiuty,sqce,tarm .In;'iana c:> i. ~ -:Jt) /?
S;.natureofOwn, Authori,edA..n" /p,;n' ~
OFFICE USE O.lLY: ********************~******************************,***?**** ***************
'~ ./ FI'F .7
INSPECTIONS REQUIRED: I mg ees:
~ . . Base Inspections: ) 1',).. '" ()
pper FO..otlng Lower Footing . Under Slab ' J;' 5" . J"6
~ Cert. of Occupancy:
.Rough m ') Meter Base Final Site ~
' P,R.I.F.: i Additional Fees
j . 1'11-/ s-30vo7 ( ~7~L: ~~/;.l3. ?jI
'yiewed/Approv d: Dept 01 Community Services (Date) V~ ~ I
Early Release
Permit:
Lot Split:
_y0
_Y~N
\
'Tlits/FormsJILP RESIDENTIAL
\
Which plumbing codes will be applied to the construction:
o International Residential Code w I~~iana Amendments
o Uniform Plumbing Code w/In.-Q~endments
o..,J:;"";'o
FOUNDATION TYPE:..,~'el:~~''that a.R!!.!v for the new
construction area)C,o'~ if' t '0' 0"''' ~
~~P6G~'~90~#'t~t:;)~tM'_PIER
~~~\\~ 'r?~(l\Q:KOlfT:_Y---7-N )
# Charged Re-
Reviews
Date
Fee Received by: