HomeMy WebLinkAbout07070099 Application
City of Carmel/Clay Township Permit #:o707DOQ 9
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:
NAME:
STREET ADDRESS:
Hco90
rJ
8:5
V'()f;1CJ 0 J .4tJ
Ftu-rs
BUILDER;~r;J;'DS~~ pl-\tW
PHONE:
S 75 d-3S"V )( cU)f:,
STATE:
CAe-M.SL
FAX:
NAME:
STREET ADDRESS:
3A-mb
LOT #: 3
CITY:
l/-(;,D 3:J-
BEST METHOD OF CONTACT:
-e..M
IL
PHONE:
FAX:
CITY:
STATE:
ZIP:
cST u.A
;3r,
ZONING:
s-
SQUARE SUvj
FOOTAGE: TO
SEWER UTILITY
PROVIDER: 0.-R TIN'
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA I BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'5 (IF APPLICABLE):
EST1MATED COST OF CONSTRUCTlON: '3 Joe 9
(EXCLUDING lANO VALUE) c7- J
A-1- ~oe 51 c.. .
FLOOD ZONE AREA DESIGNATION(S) It
FOR THIS PROPERTY:
TYPE OF CONSTRUCTION:
s-5iNGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions. Remodels. Etc.)
Early Release
Permit:
PROJECT INFORMATION:
Lot Split:
_Y~
_Y ~
I'
TYPE OF IMPROVEMENT:
s-NEW STRUCTURE
o ROOM ADDITION(S)
o PORCH ADDmON(S)
o DECK ADDITION(S)
o REMODEL
_ Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION
Manufactured
Trusses:
Sump Pump:
<----v _N
~_N
r--r39E:u--w-35 - 002-00
PLUMBING CONTRACTOR:
btkWl M 0.\.-:;; 0 tJs
Plumber's Indiana State License #:
Ul Do D { 6..\: -;;--:- -:;
: \]1. ':'. .', . .
Which plumbing codes will be applied to the construction: -~.. , I
~./C ,/II '.1
~lntemational Residential Codeiw/lndiana Amendments I I t 1,
'I' " " 1111 1 ':l ')1107 '1'1
o Uniform Plumbing Code ~Oi.I~~iana 'AJ:hendtneht&u , i i i} I
II ~, J I c//
FOUNDATION TYPE: (Check all,that apply,for.thenew c_, I
construction area) I
o CRAWLSPACE .ct.\Yr~EAM==PIER----1
o SLAB C>I--1lASEMIoN+~~ . Dy_N)
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this pennit is valid only if construction corrunences within 180
days of the date of Issuance of the bUlldmg pernut, and must be completed (Ce,gtl.ci-t~of Occupancy Issued) Wlthm 18 months of the Issuance date Class I
structure penruts are subject to the General AdnunIstratlve Rules of the State oeI~6!?P'JI1iOlttt;ga;:?mg expIratiOn tune frames for begmnmg and
oompktmgc~ vUNSTRurTI
I, the undersIgned, agree that any constructlOn, reconstructIOn, enlargement, relocation,-"~)r;:It~r~(~~\JfH!iqHHtBtllJ'li9, WffW;;:har;t.B:}1'ftM: ONf land or structures
requested by thIs application will comply With, and conform to, all applicable Jaws C\4~~tate &tlI~mtlC~' t f :+'Q!:\I,n~5tlqrnaBulat~e1 IndIana -1993~ (Z~
289) and amendments, adopted under authonty of I C 36'7 et seq, General Assembl~t:I1Rlta€lffI~lftY ' aIt'A-t'rS ~~ry thereto I further cernfy that only
kitchen, bath, and floor drams are connected to the samtary sewer I further cer~1ttv~F"Etrudt6: hb\HiftlJ't'~ed until a Certificate of
Occupancyhasbee ,IS ued by the. Departmenl ofCommuruty SeTVlces, Canner":r"mfiahl, 'ARMEL / C~~~ ES
/' - ~'UA.A1 " \~F: ~~f:;k'i9WNSHIP7/lI/o7
of Owner or Authoriz Agent Print Date
(
'OFFICE USE ONLY: ******************************************************
Filing Fees:
Base Inspections:
INSPECTIONS REQUIRED:
(lIpper F.Q.Otln!l("low;;;;;ting Under Slab
<:::R:;;:~etei)ase Final Si~
&/~
dO
..;; 5- j{!
P.R.LF.: / ;; &; j, () 0 Additional Fees
~ TOTAL:' ~~S)~-.AJ
r{Jld/t/ {21 ~ -41V1. <'ll
Fee Receiv bv -1/;2J5',b"7
**~**i'C'*****************
o
# Charged Re-
Reviews
Cert. of Occu pa ncy:
(Date)
Reviewed/Approved: Dept. of Community Services
S;Permlts/FormS/ILP RESIDENTIAL