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HomeMy WebLinkAbout07080184 Application°""""`•, : City of Carmel/Clay Township Permit# RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION .?xoup.P/ For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures BUILDER OF NAME' VtM ?C PHONE: FAX:3i / ?I 2] 1Q l / 3J b RECORD: SPXET ADDRESS: Dr ( Td STA : IP: Z7 (? e Gm lpw?b BUILDER'S EMAIL ADDRESS: IaEST_f1ETHDo OF.CONTACT: A PROPERTY NAME: / /PH 1 ?cl ! G I??. FAX: OWNER: I STATE: ZIP: STREET ADDRESS: G LOCATION LOT /Ift SUBDIVISION NAME: ?I I I ?rl Y l SECTION: C ZONING: ??I ? PROJECT & INFO: ADDRESS OF CON UCTION: 53 tee SQUARE ?J L SEWER UTILITY WATER U-n VIDER I 11 ESTIMATED COST OF CONSTRUCTION: Imo(/ /'I 7 l 1( l ? (EXCLUDING LAND VALUE) PROVIDER: \ PRO : _ 1 r J UUU EXCAVATION CONTRACTOR; PLAN COMMISSION] BZA! BPW DOCKET )i , 1 NAME OF UTILITY \( ? OR SEPTIC PERMIT #'S (IF APPLICABLE): ' l/ ( ` NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/ O FLOOD ZONE AREA DESIGNATION(S) TAX MAP PARCEL FOR THIS PROPERTY: TYPE OF CONSTRUCTION: O /SINGLE FAMILY ©' TOWN HOME O TWO FAMILY # of units being constructed at this time: O RESIDENTIAL(For Additions, Remodels. Etc.) PROJECT INFORMATION: Early Release Permit: _Y-t Lot Split: Y _N TYPE 61F IMPROVEMENT: Q NEW STRUCTURE O ROOM ADDITION(S) O PORCH ADDITION(S) O DECK ADDITION(S) O REMODEL _ Basement Finish only _ ACCESSORY BUILDING O DETACHED GARAGE O ATTACHED GARAGE n nFMOI MON Manufactured Trusses: Sump Pump: _Y PLUMBING CONTRA OR: c_ va,ta- E I? l Plumbers Indiana State License #: 101 TI-1 Which mbing codes will be applied to the construction: LV,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 O PQgiAGX (YftAkl -PIER _Y_N ) For Single Family and Two Family dwellings, additions, remodels, and/or accessory strucrute4,4ttP9 g davs of the daze of issuance of the building permit, and must be completed (Certificate of structure permits are subject to the General Administrative Rules of the State of Indiana (See 675 LAC : I, the undersigned, agree that any ct t or., or alterati2tti3fdst ntiy+ Trit requested by [his application -"ill co u E State of lp;jl¢LSI/a© e Wiring EL o 269) and amendments, a ed under uthonry of t. n6-7 et seq, Ger.era] Assembly of the State o aaa, and all.Acts arrendatori the: kitchen, bath, aid floor are connected to the sanitary sewer. 1 further certify that the construction will not be used or occupier ` Oc qy been i u by the Deparunent of Community Senices, Cq[pt}I, Indo ?? ?n/I ` r Signatureof Oamer or zwthonz Agent Print IY ``g`(g 'gg 180 sl tee of land or structures atmeI Indiana-199 (L to. I Further certify that only until a Cemb"te of g/.i 67 Date *s******s***************:**s**s***************************r**** *xs*»*********:* OFFICE USE ONLY: I PECTIONS REQUIRED: Filing Fees: Base Inspections: ?1 g• 7 E J 0 charged Re- Upper Foo ' Lower Footing der 5 Q Re'^ews Cert. of Occupancy: • S ough I Meter Bas Final Site P. R.I.F.: l I ©? Additional Fees RFlI C" 115?? 77-07 TOTAL' ?a7?• ©U Reviewed/Appro : Dept. of Community Services (Date) S:P Its/Toons(IlP RESIDENTIAL Fee Received Date