HomeMy WebLinkAbout07080078 Application..
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City of Carmel/Clay Township
Permit #:Ljq?00 70
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER
OF NAME: PHONE: FAX:
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RECORD: STREET RESS: CITY: STATE: ZIP:
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EMAIL
BEST METHOD BU"J'OA NA qE RESS:Stl Epri 603 G) ?Te OF CONTACT:
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PROPERTY FAX:
e PHONE:
NAME:
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OWNER:
STREET ADDRESS: CITY: STATE: ZIP:
LOCATION
& PROJECT LOT#_: SUBDMSIO?N?j ME: _ SEC 10
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INFO:
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FOOTAGE: ?3
SEWER UTILITY
PROVIDER: l01 WATER UTI 1 _
PROVIDER: LrI'!
G ESTIMATED COST OF CONSTRUCTION: I
(EXCLUDING LAND VALUE) /
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA 136 DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE): Jlti K t
FLOOD ZONE AREA DESIGNATION(S),I . , 6? 06 f?!T'?JI ..
FOR THIS PROPERTY: '?(y on p U/ TAX MAP PARCEL #:
1109-19-M-01-044-000
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT: PLUMBING CONTRACTOR: •L
' ( Q
5- INGLE FAMILY CYNEW STRUCTURE fJI&NA ill \
O TOWN HOME O ROOM ADDITION(S) Plumbers Indiana State License #:
? TWO FAMILY ? PORCH ADDITION(S) ?sPi (?D?' l
# of units being .-7 DECK ADDITION(S) V
constructed at this ? REMODEL Which plumbing codes will be applied to the construction:
time: Basement Finish only
O RESIDENTIAL (For O AC_CESSORY BUILDING DTtemational Residential Code w/Indiana Amendments
Additions, Remodels, Etc.) ? DETACHED GARAGE
O ATTACHED GARAGE D Uniform Plumbing Code w/Indiana Amendments
PROJECT INFORMATION: O DEMOLITION FOUNDATION TYPE: (Check all that apply for the new
Early Release Manufactured construction area)
Permit: _Y Trusses: ?__?Y_i. O CRAWLSPACE O POST BEAM -PIER
Lot Split: _Y ? Sump Pump: _tZY N 1,,?tlg SLAB BASEMENT (WALKOUT: Y N )
For Single Family and Two Family dwellings, additions'®'?a ory ?[§?}{C.Jiwu-permi[ is v v 'o within 180
davs of the date of issuance of the building ?e co, th'e Rtm (G:?Ffi a[tt oo Occupancy issued) Mont o the issuan e. Class I
S??•o,' I¢d?ai pt toee¢ 12) regaz ' expiration t e fir fo g and
structure pernuts are subject to the Genera] A U MGM,
'?o'gt2tawtS'ifittMgFp-oItV1 AUG 1'i20?
L the undersigned agree that any construction, reconstruction, ea atftflvdNc4Uon, or a! {{pcture, o ctange in the use of land co _ courts
requested by tLis application will comply with, an rQi1I p Ica law? tISA'$talebfTneiana, and the'Zo "ng Ordinance of Cannel indiana - 93'(2-
289) and amendments, adopted under authority of r[se?)rbTv o the State of Indiana, and all?.c endatory thereto. I further cer fy that only
kitchen, bath, and floordrains areconnected to wen. I furtl'e? the construction will not c of
ent o Community Services,' armel, Indiana.
Occupancyhas been issueImp
?bll `lOAnINEtIEP tf 5'l0 0r7
Slgnatu:eof Own or AuthorizedAnent Print Dale
OFFICE USE ONLY: *xx**********x********x**xxxxxxxxxxxxx****xx*x**xxx*xx: x**rr.xxxx*xxxx****.**xxxxx
INSPE S"REQUIRED: Filing Fees: 36
-? Base Inspections: ?? (J # Charged CUpperFootin tin Lower Foot Under Slab - Reviews
Cert. of Occupancy: S. 6
Rough eter Ba coal Sim
P. R.I.F.: U0 Additional Fees
?Qe? F [Ism 9-?{ 07 ?? 1, 1- 30
Reviewed/Approved: Dept of Community Services (Date) ?-
S:Perml[s/FOrmaflLP RESIDENTIAL
Fee Received bv: Date