HomeMy WebLinkAbout07090118 Application' ('t Of CRq?
City of Carmel/Clay Township Permit #:07090I03'
RESIDENTIAL IMPROVEMENT LOCA P RMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, i io s, Remodels, & Accessory Structures
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BUILDER NAME. PHONE: FAX:
81fb^'2-070
OF
RECORD: STREET ADDRESS: QTY: STATE:
alsy G-Ia.l? ? sre aoD 1•,r,?1 ZIP:
Div 4 6 o3a
BUILDERS EMAIL ADDRESS: BEST METHOD OF CONTACT:
dt.v;cl P DBKI=t;n,. feYyt oN?
PROPERTY NAME: PHONE: FAX:
OWNER:
STREET ADDRESS: CITY: STATE: ZIP:
LOCATION LOT SUBDIVISION NAME: //II SECTION:
d ZONING:
,d
P
& PROJECT 't Sow
y&0 `4`R I o? asT k--
INFO: ADDRESS OF CONSTRUCTION: l!
F SQUARE
FOOTAGE:
a 15 1 b,-) O
Y?r
SEWER UTILITY WATER UTILITY ESTIMATED COST OF CONSTRUC TION:
hr
r
PROVIDER: C-r W D PROVIDER: !' _ ,rwa I I. i 1 0 r (EXCLUDING LAN ?
(?? (D
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION J BZA { BPW DOCKET )/..('
ANDJOR COUNTY WELL AND; OR SEPTIC PERMIT #'S (IF APPLICABLE):
k- K
NUMBERS
TAC DATE
S
'
'
; RV
(
);
I ' X cq ? I i
C)N
FLOOD ZONE AREA DESIGNATION(S) 6)7c)g 0 11(p TAXMAPPA g4#:bEF 2 5 ZUU/
FOR THIS PROPERTY: X
TYPE OF CONSTRUCTION:
X SINGLE FAMILY
O TOWN HOME
O TWO FAMILY
# of units being
constructed at this
time:
CD RESIDENTIAL (For
Additions. Remodels. Etc)
PROJECT INFORMATION:
TYPE OF IMPROVEMENT:
NEW STRUCTURE
O ROOM ADDITION(S)
O PORCH ADDITION(S)
O DECK ADDITION(S)
O REMODEL
_ Basement Finish only
O ACCESSORY BUILDING
O DETACHED GARAGE
O ATTACHED GARAGE
O DEMOLITION
Early Release ? Manufactured
Permit: _Y --tl Trusses:
Lot Split: _Y ,-0 SUMPO ¢ ,
For Single Family and Two Family dwellings, additions, rrfnbdcl : VdA
days of the date of issuance of the building pe Eist)(iea:ohtple
structure permits are subject to the General A " tIv} ljatlAayytlie
)-l-`t Y" ? colnpl
Mps valid only if construction commences within 180
issued) within 18 months of the issuance date. Class I
12) regarding expiratioimeframes for.beginning and
Yf
I. the undersigned, agree that any construction, reconstruction, enlargernAl,`'QCocatio`n, or alteration of a structure, or cage m the use of land or strucrur,
requested by this applicatior will comply with, and conform to. all applicable laws of the State of Indiana, anal the" ,mg Ord:'rance of Camel Indiana -199r
239) and amendments. adopted under authority of I.C. 367 et sec, General Assembly of the State of Indiana, and al. cts amendatory thereto. 1 further certify tF
kitchen., bath, and floor drains are connected to the sanitary sewer. I further cernl , that the construction will of be used or occupied until a CertiC e of
Occupancyly s been issued b?y the Depaztm of Cotnmu ' Services, C el, Indiana ?f
4' ?t?rsl ?i ?Q t `K
Its
Signature of Owner or A __-Pwnt bale
OFFICE USE ONLY:
pper
Sye JWFOrnsr u, RESIDENTIAL
Final
of Community
PLUMBING CONTgAAaR-
Plumber's Ini'fian State Licen ,
Which plumbing codes will be applied m the construction:
'IS?Intemational Residential Code w/Indiana Amendments
O Uniform Plumbing Code w/Indiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
corLsti;yqt'W area)
D"-Zs A ?i•' WWL.SPACE O POSE BEAM -PIER
::t=T all
SLAB S, BASEMENT (WALKOUT:_Y_0
^' kJr?G? I
Filing Fees: q -
Base Inspections: o , Su # Charged Re-
Reviews
Cert. of Occupancy: S7 ' S-0
P.R.I.F.: Additional Fees
TOTAL: r
Fee
Date