HomeMy WebLinkAbout07070187 Application
(;Jty of Carmel/Clay Township Permit #:Jr1iU..DJ.R7
/KESIDENTJAL IMPROVEMENT LOCATIOfi-PERMI:rPPLICATION
For Single Family, Town Home, &. Two Family: New StructureYdditions Rem(;dels, &: ~cceSSory Structu~es
NAM'::....- L-IffClL.\ ~ V\~'S lj ~t l<..J'~ PHONE:S FAX: \
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BUILDER
OF
RECORD:
STREET ADD
ESS:
I-m <;, Rav
BUILDER'S EMAIL ADDRESS:
PROPERTY
OWNER:
NAME:
STREET ADDRESS:
LOCATION
&. PROJECT
INFO:
LOT#:
'Sa
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C
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CITY: '/.i 1/ I
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FAX:
, Sf ATE:
T
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Od
..........., / :,SQUARE
" ............. II i ~.OWAGE:
ESTIMATED COST OF'cqNSTRurnON~</U' ~ J
(EXCLUDING LAND VALUE), / ~~.
......
'-......./
00
ZIP:
ADDRESS OF CQNSTRUcnON;
27D'f{F'
SEWER UTILITY
PROVIDER:
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'$ (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.)
PROJECT INFORMATION:
Early Release
Permit:
Lot Split:
_Y~
_Y~
-X
TAX MAP PARCEL #:
\~ \D II ~O'3 0
PLUMBING CONTRACTOR:
TYPE OF IMPROVEMENT:
o NEW STRUCTURE
o ROOM ADDITION(S) Plumber's Indiana State License #:
Ji!. PORCH ADDmON(S) ~t.
8- DECK ADDmON(S>((O"Oe(~
o REMOBDEL t F' . h I Which plumbing codes will be applied to the construction:
_ asemen InIS on y
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION
o International Residential Code w!Indiana Amendments
o
Uniform Plumbing Code wI Indiana Amendments
Manufactured
Trusses:
Sump Pump:
FOUNDATION TYPE: (Check all that apply for the new
construction area)
YvN'
Yth
o CRAWLSPACE jl!:I POST & X- BEAM _PIER
o SLAB 0 BASEMENT (WALKOUT: Y_N)
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this permit is valid only if co t
days of the date of issuance of the building permit, and must be completed (Certificate of Occupancy issued) . c ate. Class I
structure permits are subject to the General Administrative Rules of the State of Indiana (See 675 lAC 1, eat es for beginning and
completing construction. ~ .
I, the undersigned, agree that any construction, reconstructio~~t, relocation, or alteration 0: s, ,any change in the use of land or structures
requested by this application will comply with, and conforg:vro, all apP!iCable-~of the State of Indiana, d the ~Zoning Ordinance of Carmel Indiana - 1993~ (z-
289) and amendments, adopted under authority of I.c. 3 et seq, General Assem ly of the State of Indiana, and all Acts amendatory thereto. I further certify that only
kitchen, bath, and floor drains are connected to the sa tary sewer. I further cer' that the construction will not be used or occupied until a Certificate of I
Occupancy has been issued by the Department of umty SeIVlc"Canne Indiana
<~ t:' '-'-r~w ,- J-lr 01-
Signature of Owner or Authorized Agent lnt Date
I
OFfICE USE ONLY: ************* *******'* ******* * *~~ ******,*** **********i********9'O****** *** ** * ****;**
INSPECTIONS REQUIRED: Filing Fees. 1 (), .-0 .
Base Inspections: / "/ ;;;. :) 0 X 3:
Cert. of Occupancy: 'SS-. 5V
Lower Footing
Meter Base
Under Slab
# Charged Re-
Reviews
@al
.~
Additional Fees
;$3:1f. Yo
P.R.I.F.:
~-
TOTAL:
l~
Reviewed/ Ap, roved: Dept. of Community Services
S:permits/FormsflLP RESIDENTIAL
Fee ReceIved by:
Date