HomeMy WebLinkAbout07060225 Application
City ofCarmeI/Clay Township Permit #: 0 7(5(d)~
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
&. PROJECT
INFO:
SEWER UTILITY
PROVIDER;
NAfj'1
I LU.-tf tfOvnES
STREET ADDRESS:
ll5CJO '" m5RJ 0
BUILDER'S EMAIl ADDRESS:
~OA NNC ,Sl4tP\4EQ..O
SAmG
NAME;
STREET ADDRESS:
lOT #:
50'L
PHONE: FAX:
5 5;,)650 X d00
CITY:
-ST
iPliLfE '
STATE:
CNJ;lb/-;
ZIP:
L./ 100'3 J-
BEST METHOD OF CONTACT:
JIY1 e J-iA i L
PHONE:
FAX:
CITY:
STATE:
ZIP:
?io
ZON~G:_ -:L
SQUARE 2Z5& UN I
FDOTAG .
WATER UTILITY /1 ^ J) I Jr
PROVIDER: 0-\1<.JV'~
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION I aZA I BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'$ (IF APPUCABLE):
FLOOD ZDNE AREA DESIGNATlDN(S)
FOR THIS PROPERTY:
TYPE OF CONSTRUCTION:
o SINGLE FAMILY
ISY'TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions. Remodels. Etc.)
PROJECT INFORMATION:
Early Release
Permit:
Lot Split:
/
~&
TYPE OF IMPROVEMENT:
cvl'NEW STRUCTURE
o ROOM ADDITION(S)
o PORCH ADDmON(~'
o DECK ADDITION(~
o REMODEL
Basement Fin
o ACCESSORY BUILD.
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLmON
-1 Set Kl
TAX MAP PARCEL #:
17-oA~3~~03-03-073.
,JPLUMBING CONTRACTOR:
t\lumber~ ~te ~c~s?#~ I N~'
,} GPIOOO 101
Which plumbing codes will be applied to the construction:
~ International Residential Code w IIndiana Amendments
o Uniform Plumbing Code wjIndiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area)
Manufactured
Trusses:
Sump Pump:
_\-(' _N
_Y _l-f<(
o CRAWLSPACE
c:v/s'LAB
o POST &
BEAM _PIER
o BASEMENT (WALKOUT:_Y_N )
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this permit is valid only if construction commences wit~in 180
days of the date of issuance of the building permit, and must be completed (Certificate of Occupancy issued) within 18 months of the issuance date. Class I
structure permits are subject to the General Adminilif~~~s of the State of Indiana (See 675 lAC 12) regarding expiration tlflfn. si~~~g:lhd
S. oli:~~cJl\'!-.truction. ~M 1'1 u ft u ~\U:"'i.lb
I, the undersigned, agree that any construction, reconstrb'.Qj~trt@r ~t,WfuT:a\idUt'U . of a structure r C JIgeQnWUI'le lalAd or structur~s
cequ""d by this application will comply with, and confonn to. "8PRP~~tb<'f",~G;rI0AAc "Zo mg rdinancc of Canncllndiana - 1993" rZ'
289) and amendments, adopted under authority Of. L~~Sk. (Jeh~r;J!jY. oH~e Sglkbjge~ aJCI'all Acts amendatory thereto. I further certify dmt only
kitchen, bath, and floor drams are connected to th~p.j.t(~ ;!~It~ . 9rrtRl~G61~.[Uci:iO'rlQ.RBnot be used or occupied until a Certificate of
Occupancyhasbecni"ucdb thcDcpartmcntdl'{!.~t.m5t" N~.~ .
~ ~1~'BPH&QO ifl/wlol
Signa re of OWn or Authorized Agent P N J" HIP Date
ONlY:*******************************************************~**~**~******************
cnONS REQUIRED: Filing Fees: ;:;<f-/!; .2b
Lower Footing Base Inspections: . . -
Cert. of Occupancy: z"'')' ~()
P.R.LF.: /~ Ai vO Additional Fees
~TOT~:' lY;/d0' c!o
_~. _, ___ _-/k07
Fe ed by; Date
# Charged Re-
Reviews
Reviewed/Approved: Dept. of Community Services
(Date)
S:PermitsjFOffi1sjILP RESIDENTIAL