HomeMy WebLinkAbout07080160 ApplicationD I U/n
City of Carmel/Clay Township Permit #:07
% RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
JNnuRA.i. ? For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER PHONE: 3 1 7 _ Z_L' -1 1 FAX: 3 I7 -1 2I
NAME:
OF p 11
lL Unli1vLQ T C. wcG (A li .-x-- i s
RECORD: ADDRESS: CITY:
.' " 137 SOW T STATE:
d, :.S s 10 ZIP:
L/(o 2 Sn
BUILD RS EMAIL ADDR
ESS: BEST METHOD OF CONTACT:
CA
h
_? /•
PROPERTY
OWNER: NAME'A PHONE: FAX:
CAW
/`'u
STREET ADDRESS: nn - CITY:
3?1?y Ll'rwin?G? (tik; STATE:
tU? Z?! ZIP:
` (d 03,a
LOCATION
& PROJECT LOT #: SUBDIVISI N NAME:
fl a s h rc . SECTION: , ZONING:
S Z
INFO: ADDRESS OF CONSTRUCTION:
391b 841-[Jln i cvl /I 1,t L'?t
/_
SQUARE SrCD
FOOTAGE:
SEWER UTILITY
PROVIDER:
h /)
°L WATER UTILITY
PROVIDER: /t /1
/ 1 Is ESTIMATED COST OF CONSTRUCTION: /
(EXCLUDING LAND VALUE) too
/
NAME OF U71UTY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / SPW DOCKET
'
NUMBERS; TAC DATE(S
S (IF APPLICABLE):
); ANDICR COUNTY WELL AND/OR SEPTIC PERMIT #
NO,
NO,
FLOOD ZONE AREA DESIGNATION(S) TAX MAP PARCEL
FOR THIS PROPERTY: h
11 )O.
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT: PLUMBING CONTRACTOR:
1K SINGLE FAMILY ? NEW STRUCTURE ' I 0?-
? TOWN HOME ? ROOM ADDITION(S) Plumber's Indiana State License #:
? TWO FAMILY f? PORCH ADDITION(S)
# of units being DECK ADDITION(S)
constructed at this O REMODEL Which plumbing codes will be applied to the construction:
time: Basement Finish only
? RESIDENTIAL (For _
? ACCESSORY BUILDING O International Residential Code w/Indiana Amendments
Additions. Remodels. Etc.) ? DETACHED GARAGE O Uniform Plumbing Code w/Indiana Amendments
? ATTACHED GARAGE
PROJECT INFORMATION: ? DEMOLITION FOUNDATION TYPE: (Check all that apply for the new
construction area)
Early Release
Permit: Y N Manufactured
Trusses: _Y t N BEAM -PIER
D CRAWLSPACE Cti
egg
Lot Split: _Y ? N Sump Pump: _Y ? N O SLAB 'P-QU`j-f:Y_N )
For Single Family and Two Family dwellings, additions, remodels, and/or accessory sm
days of the date of issuance of the building permit, and must be completed (Cer
structure permits are subject to the General Administrative Rules of the State of In
completing cons
1, the undersigned, agree that any cons=cdon, reconstruction, enlargement, relocation, or a
requested by this application will comply with, and eonfe:m to, all appliea_Ie llaws of the Stp
289) and arnendmerts,adoo.ed under authodcy of I.C. 36=re- sN GGer-eral.Asseu?bly of the
c sa arv sewer. Ifurther eert)fv that tle
kitchen, bath, and Boor d gins are connected
Occuyapcyhas been issued by the Deparnnent of Community Services, C-yf, Indiana.
ces within 180
date. Class 1
rl a a?y(ed?ge in the use o land or srructures
??t Noce o: Carmel Indiana -1993'(7
"
'.Sn1d all endatory thereto. I further cer?fy that only
will not used or occupied until a Certf&cate of
3? L. C/a- s i o?
Siq Lure of Owner or Authorised Agent of ??
OFFICE USE ONLY: xxxxxxxxxxxxxxxx xsxxxxxxxxxx xxxxsxxxxxxxxxxsxx?r xxxx xxxxxxxx*xxxx*xxx
Filling ng Fees:
INSPECTIONS REQUIRED: # Charged Re-
pper Footin Lower Footing Under Slab Base Inspections:
5-Q Reviews
Cert. of Occupancy:
Rough In Meter Base nal S P. R.I.F.: Additional Fees
City M1sE? F-70-0
Reviewed/Approved: Dept. of Community Services (Date)
S:Pemdts/FO OUR RESTDEM AL
Fee Received. by: