HomeMy WebLinkAbout07090049 Application,?tiio?r-0aA,
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City of Carmel/Clay Township
Permit #: U?U -`coq I
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
1
BUILDER NAME. PHONE: FAX:
OF
RECORD: STREET ADDRESS: CITY: STATE: ZIP:
BUILDER'S EMAIL ADDRESS: METHOD OF CONTACT:
Ut` ? -
i
PROPERTY NAME: PHONE:
4
OWNER A
1/
: STREET ADDRESS: 7 CITY: STATE: ZIP:
LOCATION
PROJECT LOT #: SUBDIVISION NAMEAle SECTION:
% (Z u ae k /CA or
?/ -? ZONING:
S
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INFO: ADDRESS OF CONSTRUCTION
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FOSQUARE
OTAGE:
SEWER UTILITY
(
C WATER UTILITY
PROVIDER:
:
ESTIMATED COST OF CONSTRUCTION
(EXCLUDING LAND VALUE)
Z/ `PQ
PROVIDER: ?
54 L 0
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOIXET
OR SEPTIC PERMIT #'S (IF APPLICABLE): T
NTY WELL AND
1
077
NUMBERS; TAC DAT
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/
OR COU
E(S); AND,
OK
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FLOOD ZONE AREA DESIGNATION(S) 1 1.
46
-7
90 I AX MAP PARCEL
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FOR THIS PROPERT Y: 0
0
0 Z
O TOWN
o TWOF
#o
O RESIDENTIAL
Additions. Rei
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PROJECT INFORMATION:
Early Release
Permit: _Y JN
Lot Split: Y ?N
STRUCTURE
0 DEMOLITION
Manufactured
Trusses: 11 Y <11 _N
Sump Pump: ? _N
D RO ADDITION(S)
O M ADDITION(S)
ECK ADDITION(S)
O REMODEL
_ Basement Finish only
D ACCESSORY BUILDING
O DETACHED GARAGE
? ATTACHED GARAGE
Plu ber's Indiana State License #:
lIV 777
Which plumbing codes will be applied to the
C? temational Residential Code w/]
O Uniform Plumbing Code w/IAgyG1
For Single Family and Two Family dwellings, additions, remodels, andlor accessory strurtures,
days of the date of issuance of the building permit, and must be completed (Certificate of O?cc
structure permits are subject w the General Administrative Rules of the State of Indiana (SeeV
(< ` Kj
?'?6 1376
ruction: C-k
?eAdments
apdTr the new
t qN?Q
N'BEAM -PIER
Ned.. commences within 180
of the issuance date. Class I
time frames for beginning and
_...r._._.e
1, the undersigned, agree that my co=uction, reconstructior, enlargement, relocation., or alterati of a structure, or any ehaage in the use al land or structures
requested by this application grill camply with, and wnfo= to, all applicable laws of the State of Indiana, and the "Zonirg Ordinance of Carmel Indiana -1993" (Z-
299) art: amendments, adopted under authority of I.C. 36-7 et seq, General Assembly of the Start of Indiana, and all Acts amendatory thereto. I further certify that only
kitchen, bath, and t7oor drains are connected to the sanitary sewer- I further certify that the construction will not be used or occupied until a cerriGcam of
Occupanc}'has been issu d by Deparnnent of Community Services, Carmel. Indiana.
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5'g aD Authori l! t Date
x***xxxsx****xxxx*xxxx*x*xx****xxx**xx**xxxx***xx*xxxx***x***xxxx****x***xx**xx**
OFFICE USE ONLY:
Filing Fees:
I SPECTIONS REQUIRED: B Charged Re-
Base Inspections: Reviews
Upper Footing ower Fotin Under Slab SS )?
Cert. of Occupancy:
Rough In Meter Ba Final Site P.R. .F.: 00 Additional Fees
T TA
3-07 O ??
v M M l S -
ted: Dept. of Community Services E?ftted: Dept. of Community
S: Permrts/Portns([lP READENnnL Fee Received by: Date