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HomeMy WebLinkAbout07080173 ApplicationCity of Carmel/Clay Township Permit #: 6702 or 7 3 RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION `Zl.,, For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures BUILDER NAME 9 /Y PHONE' FAX: Y?-z9 yz- ky C_ u OF " - RECORD: STREET ADDRESS: r ?? STATEN ZIP: z /I 2} ?cA _ d BUILDER'S EMAIL ADDRESS: ?I ?S P4 (tip / BEST METHOD OF CONTACT: C?V ?'? ??S.l v:. PROPERTY NAME. PHONE: FAX: OWNER: STREET ADDRESS: CITY: STATE: ZIP: LOCATION LOT': N NAME: 2a' Q R ON iF`kD cem 'n • {IM .. & PROJECT 7 nrd cg :: I a't / alts ' INFO: ADDRESS OF CONSTRUCTION: ???? and ?CCGI D OF CG ? r !I I EE 91 U 1 "? , 1 i / ? 3d t L SEWER UTILITY WATER UTILITY PROVIDER: I CD (EXCLUDING IXCLUDING LAND SSND 4740 6 TT DER: PROVI V1 u t mss- t / 1ANA V NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / SZA / BPW DOCKET IF APPLICABLE): E IT #'S NUMBERS; TAC DAT RM ( E(S); AND/OR COUNTY WELL AND/OR SEPTIC P FLOOD ZONE AREA DESIGNATION(S) TAX MAP PARCEL #: C FOR THIS PROPERTY: ? TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT: PLUMBING CONTRACTOR: ?fCA?Q? ? JINGLE FAMILY ?-4EW SIRUCTU RE a ( vim. ?0 TOWN HOME ? ROOM ADDITION(S) Plumber's Indiana Stat icense ? TWO FAMILY ? PORCH ADDITION(S) 1p # of units being ? DECK ADDITION(S) constructed at this ? REMODEL rN'? 1 Which plumh' ?1 T? a It strudion: s time: _ Basement Finish only .? ? RESIDENTIAL (For ? ACCESSORY BUILDING (n t a esidential Code w/ na Amendments Additions, Remodels. Etc.) O DETACHED GARAGE Q Uniform bi`ar,<DS??ana ndments O ATTACHED GARAGE PROJECT INFORMATION: O DEMOLITION OUNDA PE: (Check all tha ply for the new Early Release Manufactured constructio area) Permit: Y _N Trusses: "Y _n O C BY PACE ? POST & _ BEAM -PIER Lot Split: Y _N Sump Pump: Y _N C B ? BASEMENT (WALKOUT: Y_N ) For Single Family and Two Family dwellings, additions, remodels, and/or accessory smermes, this permit is valid only if construction commences within 180 days of the date of issuance of the building permit, and must be completed (Certificate of Occupancy issued) within 1S months of the issuance date. Class 1 structure permits are subject to the General Administrative Rules of the State of Indiana (See 675 LAC 12) regarding expiration time frames for beginning and completing construction. 1, the undersigned, agree that any construction, reconstruction, cnlargememc relocation, or alteration of a structure, or any change in the use of land or structures requested by this application will comply with, and conform to, all applicable laws of the State of Indiana, and the "Zoning Ordinance of Cannel Indiana -1993' (2- 259) and amendments, adopted under authority of I.C. 36-7 et wq, General Assembly of the State of Indiana, and all Acts amendatory thereto. I further certify that only kitchen, bath, and floor drains are connected to the sanitary sewer. I further certify that the construction will not be used or occupied until a Certificate of Occupancyhas been issu by the Department of Community Services, Camel, Indiana ?? R L = .ee G? f3rd? vim. e?m,...:.M.Sow.rl t Date OFFICE USE ONLY: **xxxxxxxxxxxxxxxx*xxxxx**x*x*x**x**xxxx**x*x**x****xxxx***x?:*? x**xx*...fi=====__ Filing Fees: • INSPECTIONS REQUIRED- ections: Base Ins e-? ?517 • J 0 Charged Re Upper Foo ' ag' Lower Footing nder Sla p s5 o sQ Re• sews Rough I eter Base Cert. of Occupancy: P.R.I.F.: r ?J ?Qil ©0 Additional Fees ?L7-67 AL: RESIDENTIAL Fee Received by: Date