HomeMy WebLinkAbout07080172 ApplicationPermit #: o 70 1 / a
City of Carmel/Clay Township
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
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Na a?, j For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER NAME: PHONE: -2 FAX: V Y? r q2?-y
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RECORD: STREET ADDRE
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rticc STA ZIP:
Al 6 z(Cd
BUILDER'S EMAIL ADDRESS:
I BEST METHOD OF CONTACT:
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61
PROPERTY NAME' PHONE: FAX:
RELEASED FOR CONSTRUCTION
OWNER
: $ t to compliance mtt? 3gU 2 ions ZIP:
STREET ADDRESS : of State and Local Codes.
LOCATION LOT at: 2A SION NAME : 1
J1 ? p?-y
P{MEL! CLg TO
NSHIP"f-e-
PROJECT ,
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INFO: ADDRESS OF CONSTRUCTION:
/W I SQUARE
FOOTAGE:
(
SEWER UTILITY v
PROVIDER: ?rK cvp UTILITY
WATER
PROVIDER: ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE)
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT P'S (IF APPLICABLE): / J? tam ?
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FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY: AX MAP PARCEL
T
O A
TYPE OF CONSTRUCTION:
O 5INGLE FAMILY
OWN HOME
O TWO FAMILY
# of units being
constructed at this
time:
0 RESIDENTIAL (For
Additions, Remodels, Etc)
PROJECT INFORMATION:
Early Release
Permit: _Y N
TYPEOFIMPROVEMENT:
? NEW STRUCTURE
? ROOM ADDITION(S)
O PORCH ADDITION(S)
? DECK ADDITION(S)
? REMODEL
_ Basement Finish only
O ACCESSORY BUILDING
O DETACHED GARAGE
O ATTACHED GARAGE
? DEMOLITION
Manufactured
Trusses: _Y _N
PLUMBING CONTRACTOR:
15C,
Plumber's Indiana State Lice a
/0--yo97
Which plumbing codes will be applied to the construction:
l??intemational Residential Code w/Indiana Amendments
O Uniform Plumbing Code w/Indiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area)
O CRAWLSPACE ? POST B _ BEAM -PIER
LOL Dpuc _r _i? auury ruruy. = DLFC u Dv. cmovi
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For Single Family and Two Family dwellings, additions, remodels, and/or accessary structures, this coon commences within 180
days of the date of issuance of the building permit, and must be completed (Certificate of O i e 8 rh f the issuance date. Class I
structure pemuts are subject to the General Administrative Rules of the Staze of Indiana (See g 11' a ding exp-ti e fames for beginning and
completing construction. U ec .?np"i
I, the undersigned, agree that any corstrucrion, reconstruction., enlargement, relocation, or altenvo strruu{{??yy?? at7y Ekk??e it, • =e of land or structures
requested by this application will comply with, and conform to, all applicable laws of the State of In di rdkHd _omng Ordinance qEC el Indiana -1993' (Z-
289) and amendments, adopted underauthori: of I.C. 35-7et seq, General Assembly of the Srate of In , and all Acts amendatorythere . I further cenify :hat only
k;rchen, bath, arc floor drains are coanecmd to the sanitary sever. I further certify that the construc 'on will not be used til a Cerab"te of
Occurtanev been' ued b e Department of Community Services, CC 'el, Indiana, gy
Sig re of Dwner or Authorivi Ag rint Date
:*ssxxs.*s:.s»<:*r..:x*sa»s*asszstns*s:>Y***aa*»:*:e+aa*ssss*s: sss:x:.r+«..:**.
OFFICE USE ONLY:
Fees:
Filin
g
INSPECTIONS REQUIRED: ections:
Base Ins y / . V Charged Re-
pper Foo g Lower Footin Under Slab p
(J Reviews
Cert. of Occupancy: •
oug In eter Ba I Site
P. R.I.F.:
1 0 Q ?
Additional Fees
-ZZ: a 7 ?• a a I D
Review proved: t. of Community Services (Date)
Fee Received by: Date