HomeMy WebLinkAbout07080163 Application?`"-?.., Permit
City of Carmel/Clay Township
` RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
anun?. j For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER NAME'
i ?
- PHONE:
575-19vl
31? FAX:
OF a a+ -
RECORD: STREET ADDRESS:
S6
G. CITY: SLATE:
C6.? 1 ZIP'
BUILDER'S EMAIL ADDRESS: BEST METHOD OF CONTACT:
70
7-
A v\ -rA r4) 1A I I. Co co
it p? a
0
PROPERTY NAME: j PHONE:
3i7-5375- GO
OWNER: I I'A O.-r
STREET ADDRESS:-
S{ o
Gr CITY: STATE:
Cs?r i AUG 1'
LOCATION LOT SUBDIV qN NAME: ( BSEC ION:
y 20NA
PR03ECT
&
INFO: D OF CO STRI?i N: r-0OTA
??.,
CA Y-
CA 2
SEWER UTILITY WATER Uf4fTY ESTIMATED C ST OF CON UCTION: ' I O
PROVIDER: PROVIDER: (EXCLUDING LAND VALUE) ?aO
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA i BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERM FT #'S (IF APPLICABLE):
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERLY:
, TAX MAP PARFCEELL #:
' o
0c
I S G
TYPE OF CONSTRUCTION:
O SINGLE FAMILY
O TOWN HOME
O TWO FAMILY
# of units being
constructed at this
time:
? RESIDEI rIAL (For
Additions. Remodels, Etc.)
PROJECT INFORMATION:
Early Release
Permit: Y
Lot Split: Y
TYPE OF IMPROVEMENT:
O NEW STRUCTURE
O ROOM ADDITION(S)
O PORCH ADDITION(S)
O DECK ADDITION(S)
REMODEL
Basement Finish only
D CCESSORY BUILDING
? DETACHED GARAGE
D ATTACHED GARAGE
D DEMOLITION
Manufactured
Trusses:
Sump Pump:
P MBING CONTRACTOR:
18L - ?A_
P bens Indiana State License #:
Which plumbing codes will be applied to the construction:
o International Residential Code w/Indiana Amendments
(1)0 Uniform Plumbing Code w/Indiana Amendments
Y N 772 Q
N ? f J lQ
area)
(Check all that apply for the new
O POST & BEAM -PIER
BASEMENT (WALKOUT:_
For Single Family and Two Family dwellings, additions, remodels, lindlor ace __46r stifictures, tl?permit is valid only if construction commences within 180
days of the date of Issuance of the builW9-___ t lx c pleted (Certificate o -panty issued) within IS months of the issuance date. Class I
structure permits are suW.=nply ales o e State off a (See 675 LAC 12) regarding expiration time frames far beginning and
compl t nstruction.
1, the undersilil tmctior., enlargement, relocation,, or alterarmn of a structure, or any change it.. the use of land or structures
requested by r with, and conform to, all applicable laws of the State of Indiana, and the -Zoning Ordinance of Cannel Indiana -1993" (2-
239)anda-_3.&0" ena, adopted underauthority of I.C.36.7 er see, General Assembly of the State of Indiana, and all Acts=endaton' thereto. I further certify that only
kitchen, bath, and ]oor drains are connected to the sanitan'sewer_ I further certify that the construction will not be used or occupied until a Certificate of
Cccuponcyhas,teen issued by t?epepartmeeof Community Services, Ca^el, Indiana. Y
signature of Owner or
OFFICE USE ONLY:
INSPECTIONS REQUIRED:
Upper Footing Lower Footing Under Slab
ug n Meter Base nal Site
G? ? r? •71,67
Reviewed/Approve . Dept. of Community Services (Date)
Date ' O
Filing Fees:
Base Inspections:
Cert. of Occupancy:
P.R.I.F.:
{/J`G4
SS S0
# Charged Re-
Reviews
Additional Fees
3 o9 oo
S:Pernts/FornWILP RESIDENTIAL Fee Received