HomeMy WebLinkAbout07080140 Applicationt
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City of Carmel/Clay Township Permit : , y0
RESIDENTIAL IMTROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER NAME: PHONE: FAX:
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AC4C YA,2-
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RECORD' STREET ADDRESS'' CITY' STATE:
Ja'rf-Z4 ?2?XT7?rJ L?q?t1 c-: G?Sth-=725 .?iv ZIP:
(a 3 7.
BUILDER'S EMAIL ADDRESS: BEST METHOD OF CONTACT:
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PROPERTY NAME: PHON£: FAX
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OWNER: Jlr A.)L
STREET ADDRESS: CITY STATE:
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=;Ij ZIP:
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LOCATION LOT 9: SUBDIVISION NAME: SECTION:
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. ZONING: `.
PROJECT ,
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INFO: ADDRESS OF CONSTRUCTION.
F'I
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FOOTAGE:
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SEWER UTILITY WATER UTILITY ESTIMATED COST OF CONSTRUCTION:
PROVIDER:jL
clq T,L PROVIDER: C°®L (EXCLUDING LAND VALUE)
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION; B>AI 8P1V OOCREf
NUMBERS; TAC DATE(S); AND,'OR COUNTY WELL AND/OR SEPTIC PERMIT i1S (IF APPLICABLE):
FLOOD ZONE AREA DESIGNATION(S) TAX MAP PAR - _ _
FOR THIS PROPERTY:
TYPE OF CONSTRUCTION:
SINGLE FAMILY
? TOWN HOME
? TWO FAMILY
#of units being
constructed at this
time:
0 RESIDENTIAL (For
Additions. Remodels, Etc.)
PROJECT INFORMATION:
TYPE OF IMPROVEMENT: PLUMBING C NT R
DI
Z
a NEW STRUCTURE .Y
I] ROOM ADDITION(S) L#:
plumbers' Indiana Stifte LiceL{
? PORCH ADDITION(S) - 1 li
'
iRc.- DECK ADDITION(S) CeAPG"c r
? REMODEL Which plumbing modes will be applied to the constr o
Basement Finish only
_
? ACCESSORY BUILDING D Intemational Residential Code w/Indiana Amendments
? DETACHED GARAGE D Uniform Plumbing Code wf Indiana Amendments
r ATTACHED GARAGE
?DEMOLITION FOUNDATIONTYPE: (Check all that apply for the new
Early Release Manufactured
Permit: Trusses:
Lot Split: ,Y `TI Sump Pump:
////// construction area)
Y/ Q CRAWLSPAC£ ?
Y D SLAB ??
For Single Family and Two Family dwellings, additions, remodels, and!or accessory structm
days of the date of issuance of the building permit, nud must be completed (Certificate nfv
structure permits are subject to the General Administratil a Rules of the State of Indiana (St
mmplctmg construction.
1, the undersigned, agree that any construction, recor.strucnon, Mlargement, relocat+.un, or altera
requested by this app] icationwill comply with, and conform to. J1 apptlaable laws of the S Late of
2 39) and amendment,, adopted under au[horiry of I.C. 35-7 et sec, General Assembly of the Stzre
kitchen, oELh, aid floor drains ate connected m the sanitary sewer. I further certify that the con
-h be as dh th De meet of Comznum -Services Carmel Indiana.
?1-PIER
YN )
thin 180
Cl. I
ing and
?e use oL land o: s[nattures
f =d lndi?;a-1993"(Z-
3 [o_y [hereto. I funhercenify that only
or occupltd until a Cerrzf c. re of
Qeeufrancy as en Y C I '$
Or QWnelai
Print
-/S --a 7,
Date
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OFFICE USE ONLY:
Filing
I SPECTIONS REQUIRED: Fees:
Base Inspec#icns:
U per Foot"sng ower Footing Under Slab
Cert. of Occupancy:
Rough In Meter Base Final Si
P.R.LF.:
?7Z,4LLl ?is y- Z -? G/
Reviewed/Approve ep . of Community Services ([late) ?
S!P Its/Foa,gJLa RFSIDEF L Fee Rec?h'ed by:
# Charged Re-
Reviews
??,SJQ
Additional Fees
0 0
Date