HomeMy WebLinkAbout07070084 Application
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City of Carmel/Clay Township Permit #: o'107oOlJ.{
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
{~#JGJ 1.
CITY:
7V l-t.- 13> ~
FAX:
3(t t.{ foDtffo /.f2-
STATE:
WA-tLlM t:-L 'TN
&v32-
BEST METHOD OF CONTACT:
=3lt '-lIPO 4b'f2-
NAME CO tll"\4-tN\ e 'ffL eVbeNit:eE: ? 17<0 8 (5 ~
CITY:
Cb'\-I/..-IM-e-L
SIOLJ I~",',L
SUBDIVISION NAME:
t::-1iA-WA-Il...t:' T~
ADDRESS OF CONSTRUCTION: .' --r- .
i 3 <-{ 7 S I 0" X I vL-.A-I1-.
BUILDER
OF
RECORD:
STREET ADDRESS:
(PO
P: /'f j) Il:. o.ff-
BUILDER'S EMAIL ADDRESS:
PROPERTY
OWNER:
LOCATION
& PROJECT
INFO:
STREET ADDRESS:
133'-l7
LOT#:
i JJ,
SEWER UTILITY
PROVIDER:
WATER UTILITY I' . . .. ~ f
PROVIDER: ~~
c.;.t;l.-~
NAME OF UTILITY EXCAVATION CONTRAcrOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE):
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY:
TYPE OF CONSTRUCTION:
o SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
~ RESIDENTIAL (For
Additions. Remodels. Etc.)
TYPE OF IMPROVEMENT:
NEW STRUCTURE
ROOM ADDITION(S)
PORCH ADDmON(S)
DECK ADDmON(S)
REMODEL
_ Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION
o
j
PROJECT INFORMATION:
PHONE:
ZIP:
FAX:
STATE:
.:IN
ZIP'tfb 0 3 2..
SECTION:
ZONING: fL \
ec.-
G.t/l.-v\A.{L
SQUARE
FOOTAGE:
25&::, eLi?
E.
ESTIMATED COST OF CONSTRi.910N:
(EXCLUDING LAND VALUE) :t:( eo OtJ;i)
TAX MAP PARCEL #:
PLUMBING CONTRACTOR:
Plumber's Indiana State License #:
Which plumbing codes will be applied to the construction:
o International Residential Code w IIndiana Amendments
o Uniform Plumbing Code wI Indiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area)
Early Release Manufactured
Permit: _Y ~N Trusses: _Y X. N 0 CRAWLSPACE 0 POST& BEAM_PIER
Lot Split: _Y -f.-N Sump Pump: _Y ~N )8l SLAB 0 BASEMENT (W~I,K9\{T:_Y_N )
For Single Family and Two Family dwellings, additions, remodels, and/or accessorYR&uEiA~e . '. s V I 0 !-. ~omR;l!~Kfig~unences within 180
days of the da~e of issu~ce of the building pennit: and ~ust be completed (Certif~~~h2f~~~f$Ua.t)CW\.t'frill o~'$S~ofthe issuance da~e. ~Iass I
structure penmts are subject to the General Admirustratlve Rules of the State of Indiana {See ~fM5tez~gil.t.~6lt.leIlrtIme frames for begmnmg and
completing construction. ': 1\ H INll~ SEF\V1CES
I, the undersigned, tee th any construction, reconstruction, enlargement, relocation, ~E:~i~faGQM~ttra'nycha.nge in~!j~ Vg pi Jafl~r structures
requested this a .cati ,ill comply with, and conform to, all applicable laws of th;..,~ttU.e,ow.nai'\'ffil:fpfttn.f='~ri6~i'6arlcf1Wlfh~fihHiana -1993" (Z~
289) and a e dme ts' ado t d under authority of r.c. 36~7 et seq, General Assembly ofldlll;tlteYlfndrlM, art"d'an t ~IV-9{1datory thereto. I further certify thaC only
kItchen, b h, do. are connected to the sanitary sewer. I further certify that the construction wiljfM L~~r occupied until a Certificate of
Occupanc has be , by the Depanment of Community Seme",. d. Indian.. 711l/o
_ _ ~, , 7
NLY:*******************************~********************3*~**~c?********************
SPECTIONS REQUIRE . Filing Fees: I. ' -
Base Inspections: .,..,.J 7, O.DO
Cert. of Occupancy: >). ~O
P.R.I.~" / Addlbonal Fees
~~~.y(}o
Meter Base
Site
7-1'~ r57
ommunity Services (Date)
Fee Received by:
# Charged Re.
Reviews
Date