HomeMy WebLinkAbout07060150 Application
. City of Carmel/Clay Township Permit #: (J1~b t5:J
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
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BUILDER NAME/Ioln (' S f/;I!J PHONE: FAX:
OF L qo3 - 770A. '/5 - /,;{15
RECORD: STRE/q~;ic Sf, mY: / ZIP:
?rW1-.1 /LJ
htv BEST METHOD OF CONTACT:
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PROPERTY
OWNER:
ZIP:
Y'?GJ ~
STATE:
CITY:
ZONING:
LOCATION
& PROJECT
INFO:
SQUARE
FOOTAGE:
ESTIMATED COST OF CONSTRumON:
(EXCLUDING LAND VALUE) 7C/
.J,<- dt 0
SEWER umLTIY
PROVIDER: C l' /C k/iJ
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION I BlA I BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'5 (IF APPUCABLE):
j,~
ded
TAX MAP PARCEL #:
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY:
PLUMBING CONTRACTOR:
tJ..tln~ ct t;U{L/5,
Plumber's Indiana State License #:
IT !O(!)()O(O
TYPE OF CONSTRUCTION:
"" SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions. Remodels. Etc.)
[;c
I
~
o
o
o
NEW STRUCTURE
ROOM ADDITION(S)
PORCH ADDITION(S)
DECK ADDITION(S)
REMODEL
_ Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION
Which plumbing codes will be applied to the construction:
~ntemational Residential Code w jIndiana Amendments
o Uniform Plumbing Code wjlndiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area)
J2l1 CRAWLSPACE 0 POST & BEAM PIER
o SLAB ~ BASEMENT (WALKOUT:_C.&N)..
PROJECT INFORMATION:
_yXN
_Y.)(N
Manufactured
Trusses:
Sump Pump:
Early Release
Permit:
_Y-;;X-N
..;>{..Y_N
Lot Split:
_ <--~ ',--- _ '. _ :.:::, ,J
For Single Family an.d Two Family dw~~ngs, add~tions, remodels, and/or accesso,! structures, this per:rrut is valfct~,~y,~~ory!7tr~!,c~i~~~,~~ce~~t:}rin,180
days of the date of Issuance of the bUlldmg peomt, and must be completed (Certificate of Occupancy Issued) v.?thln '~8 months.~e~~ce.date,,'c:r:las~ II
structure pennits are subject to the General Administrative Rules of the State of Indiana (See 675 IAC 12) regar<Ftig ~xpiiii:ion time frames for beginri~ arid
completing construction. il'.'! I il! JJ\
I, the undersigned, agree that any constructio. n, reconstruction, enlargement, relocation, or alteration of a structure, or finr~h~nge in~\Iseflf iAncYm:AructuFe~
requested by this application will comply with, an~conform to, all1pplicable laws of the State of Indiana, and the ~Zonh1g O~nanc\JM ~anllel lfud(a1{h" -1993i~(f>
289) and amendments, adopted under authontyof LC 36~7 et seq, Gene~l Assembly of the State of Indiana, and all ACt$ blndridatory thereto. I further certify t~r.orily'
kitchen, bath, an floor drains ar nte'd to the sanitary sewer. I furt scfrtify that the construction will not be 'Js~dl.citQ~c.upie:d llntil a,Certificate of \
Occup h~~ssue epartrnent of Community Services; armel, Indiana. J 7 L ' \
~"/, b .h . IV -fYV (' /Y' iLL ry / ~ .--I-IIf/;:;rr--
re of Owner or thoriz Agent Date! I
***********************************************************
Ilf!", (;0
(~} fi: <(0
Cert. of Occupancy: S S <)0
P,R.I.F.: I t>I G f. (jO Additional Fees
~L:v ;2',,!ZlFO~O
F Receivedbv: Y { DLJi-,! OJ
Filing Fees:
Base Inspections:
# Charged Re.
Reviews
Under Slab
(Date)
S:PermltsjFormsjILP RESIDENTIAL