HomeMy WebLinkAbout07100006 ApplicationOS Gt9?
City of Carmel/Clay Township Permit it: I OCX'?7 (_
RESIDENTIAL PdPROVEMENT LOCATION PERMIT APPLICATION
unto>'i . ` For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER NAME. PHONE: FAX:
' X17
3
OF o
RECORD: STREET ADDRESS: CITY: STATE: ZIP:
Gukju VI) S0
BEST METHOD OF CONTACT:
BUILDERS EMAIL ADDR,5
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t
-? CJ St`V tr{?.? Gv`n0. ` -
PROPERTY MANE' PHONE: FAX:
OWNER:
STREETADDRESS: CITY: STATE: ZIP:
??
75i-?.-4?
LOCATION LOTS: SUBDIV151ON NAME: SECTION: ZONING:
S -?
& PROJECT y3 r
INFO: ADDRRE55 OF CONSTRUCTION: /
1 V, 14Q%-
1 CI C? ` LJ?? SQUARE r
FOOTAGE: ( L
SEWER PROVIDER LTTI' ?ZWJ\ I`s1
RWATER O DER: ? COST OF CONSTRUCTION'
(EXCLUDING LAND VALUE)
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA I BPW DOCKET
OR SEPTIC PERMIT #'S (IF APPLICABLE): l?l \1SOr
W C?
e
( ?-
Y
ND
\
.,
WELL A
/
1
NUMBERS; TAC DATE(S); AND/OR COUNT
(S
FLOOD ZONE AREA DESIGNAn v
wow
TAX MAP PARCEL
U I I
!A`
-
FOR THIS PROPERTY:
r
TYPE OF CONSTRUCFIGN:
SINGLE FAMILY
? TOWN HOME
? TWO FAMILY
# of units being
constructed at this
time:
RESIDENTIAL (For
Additions, Remodels, Etc)
PROJECT INFORMATION:
Early Release
Permit: Y
Lot Split: Y _N
TYPE OF IMPROVEMENT:
NEW STRUCTURE
? ROOM ADDTTION(S)
? PORCH ADDITION(S)
? DECK ADDITION(S)
? REMODEL
_ Basement Finish only
? ACCESSORY BUILDING
O DETACHED GARAGE
? ATTACHED GARAGE
O DEMOLITION
Manufactured
Trusses: N
Sump Pump: Y_N
PLUMBING CONTRACTOR:
_S_V?S C_,Allet_ s
Plumbers Indiana State License #:
-*=?tW S yD
Which plumbing codes will be applied to the construction:
NorrIntemational Residential Code,w/Indiana Amendments
? Uniform Plumbing Code w(Indiana`Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area)
BEAM -PIER
OUT:_YN/ N)
For Single Family and Thvo Family dwellings, additions, remodels, andlor abbe v ? ?r on cormnences within 180
)lie ` r5?pi?
days of the date of issuance of the building permit, and must be completed (Certificate or0,? Cy }t#lr?y{at%ASfJft?Xe ipssuance due. Class I
t i ??lI?a?XDI+'91'rW"es for beginning and
structure permits are subject to the General Administrative Rules of the State ed(ytp V r _ Q
on. ?
ll iV
'n" c
I. the undersigned, agree [hat any coos[ruction, reconstruction, enlargement, rel. fib !?G??r® a e ? - ) change in [he use of land or structures
requested by this application. will comply with, and conform to, all applicable laws cur the S[a[e of Iteandiana, a 8 n Ordinance of C2 mel Indiana -1993" (7-
289) and amendments, adopted under authority of I,C. 36.7 et seq. General Assembly of the Stale of Indiana, and all Acts amendatory thereto. 1 further c,mlh that only
kitchen, bath, and floor dr r s are connected to the sanitary sewer. I further certify, that the construction will not be used or occupied until a Certificate of
-en issu d e en[ of Community Services, Carmel Indiana
y . ` -
C Z`yt? ?` 5 l??r F OL c? ?v c
Sig nor lhorizd .( ent Print Win!
*xxxxx*x***x*xxx*****xx***xsxxxxxxx**xx**x*xx*xxxxx,jxxxxxxx*****xx**x**x*:*xxxxx
OFFICE SE ONLY:
INSPECTIONS REQUIRED: Filing Fees: CJ 3 - 0
: ? CF-2 0 Charged Re-
lnnn ?o weor Foo?tin>o Under Slab Base Inspections Reviews
Rough In
Dept. of Community Services
S:PU. WFmyILP RESIDEEMIAL
Cert. of Occupancy:
P.R.I.F.:
Fee
Additional Fees
Date