HomeMy WebLinkAbout07090088 Application. tY GL ^5Fy\.
City of Carmel/Clay Township Permit#: ,
RESIDENTIAL BWROVEMENT LOCATION PERMIT APPLICATION
oFor Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER
OF NAME.
'??s v o PHONE:
-J*-l FAX:
RECORD: STREET ADDRESS: CITY: STATE: ZIP:
BUILDER'S EMAIL ADDRESS: BEST METHOD OF CO ?' I p y] I I'-
u lJ?C
?J ? d
PROPERTY
OWNER: NAME: PHONE:
3\ o-l pA?{
SCC 2 O 2007
STREET ADDRESS: CITE: ZIP:
\34ao wo
LOCATION
PROJECT LOT t: SUBDIVISION NAME:
5 J - a mss- SECTION: ZONING:
&
INFO: ADDRESS OF CONSTRUCTION:
v34ao Sco Sz . SQUAARREGE:
SEWER UTILITY
PROVIDER: WATER UTILITY
PROVIDER: _ ESTIMATED COST OF CONSTRUCTION:
(E)(CLUDING LAND VALUE) -yam WO m
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE):
/
FLOOD ZONE AREA DESIGNATION(S) -\ TAX MAP PARCEL
,
FOR THIS PROPERTY: X TML T OF CON RUCTIdN:
SINGLE FAMILY
O TOWN HOME
O TWO FAMILY
# of units being
constructed at this
time:
RESIDENTIAL (For
Additions, Remodels. Etc.)
PROJECT INFORMATION:
Early Release
Permit:
TYPE OF IMPROVEMENT:
O NEW STRUCTURE
O ROOM ADDITION(S)
? PORCH ADDITION(S)
O iDECK ADDITION(S)
Ci' RE"DEL
? Basement Finish only
? ACCESSORY BUILDING
? DETACHED GARAGE
O ATTACHED GARAGE
? DEMOLITION
Manufactured /
Trusses: Y 1
Sump Pump: 7Y_N
PLUMBING CONTRACTOR:
Plumber's Indiana State License #o'
Which plumbing codes will be applied to the construction:
561"intemational Residential Code w/Indiana Amendments
O Uniform Plumbing Code w/Indiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area)
CD CRAWLSPACCE/ O POST & _ BEAM _/.P.IER
O SLAB C7' BASEMENT (WALKOLJT:_y N )
Lot Split:
_Y ? N
_Y -?/N
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this permit is valid only if construction commences within 180
days of the date of issuance of the building permit, and must be completed (Certificate of Occupancy issued) within IS months o , h ss a date. Class I
structure permits are subject to the General Administrative Rules of the State of Indiana (See 675 LAC 12) regarding ex . for beginning and
completing construction. q
rgt 0,7 pp n e use of land or strucrares
1, the undersigned agree that any construction, reconstruction, enlargement, relocation, or alteration t
requested by this application will comply with, and confo.. to, all applicable laws of the Stare and inane of Carmel Indiana -1993" (Z-
289)and amendments, adopted under aurhod:y of I.C. 36-7 et seq. General Assembly of tie St o Inch, a}' yea amendatory thereto- I further certiryy that only
kit err, bath, and floor drains are connected to the sanitary sewer. I further certify that the c `aR n will not be used or occupied until a Certificate of
Ge pancyhas been issued b°, the Department of Community Services, Carmel, Indiana.
ke"Y-t S. 1h ?iS gt"a0- o?
Print Date
:*sxxx*s*ssxx*s:sxx*:s*a***sss>x....:.x::::?.____?__..-
OFFICE USE ONLY:
INSPECTIONS REQUIRED: Filing Fees: / / S SQ
Base Inspections: x Charged Re-
Upper Footing Lower Footing Under Slab -' Reviews
Cert. of Occupancy: 5TSQ
Rough In Meter Base Site
_C- 4.c: w h t I -2.1 - Z7
Reviewed/ roved: Dept of Community Services (Date)
5:Pe WFormO PRESIDENTIAL
I , 65!?//3
P.R.I.F.: Additional Fees