HomeMy WebLinkAbout07100021 ApplicationV Os Cagb?
City of Carmel/Clay Township Permit: I
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER
OF ME. PHONE: AX
dens" µvn(ES ?-?- SSZ-;?,31 C S2
RECORD: STREET ADDRESS: CITY: STATE: ZIP:
?yyS? !/GCri/ pwA?S.(id2? Q ra
BUILDERS EMAIL ADDRESS: LEST METHOD OF CONTA i
PROPERTY
OWNER: NAME' / PHONE: -? FAEI - 3 2007
?IDYL /y1 L G6 5 A57-?
ETA DRESS: CITY: ?STA '
5
LOCATION
PROJECT LOT #: 5 MSION NAME: SECTION: ZONING:
1`5 ;r}aR?L Oti
&
INFO: ADDRESS OF CONSTRU ON: SQUARE Z / T
!0 33® v/1 L FOOTAGE:
SEWER UTILITY
PROVIDERl// Zj iw ,4 WATER UTI
PROVIDER: ? ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE) (PJ ? ?
NAME OF LM EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA J BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT A'S (IF APPLICABLE):^X??QI/?I IL
FLOOD ZONE AREA DESIGNATION(S) ::J$ p Coo a O TAX MAP PARCEL #:
FOR THIS PROPERTY:
TYPES OF CONSTRUCTION:
C7 SINGLE FAMILY
? TOWN HOME
? TWO FAMILY
# of units being
constructed at this
time:
0 RESIDENTIAL (For
Additions. Remodels. Etc.)
PROJECT INFORMATION:
Early Release
Permit: -Y -N
Lot Split _Y N
TYPE OFAMPROVEMENT:
i? NEW STRUCTURE
O ROOM ADDITION(S)
? PORCH ADDITION(S)
? DECK ADDITION(S)
O REMODEL
_ Basement Finish only
? ACCESSORY BUILDING
O DETACHED GARAGE
? ATTACHED GARAGE
O DEMOLITION
Manufactured
Trusses:
Sump Pump:
_Y N
Y If<
PLUMBING CONTRACTOR:
Plumber's In?dyiana State Lic
C? 0J boo 1101'e)
Which plumbing codes will be applied to the construction:
O International Residential Code w/Indiana Amendments
i' EI U ifonn Plumbing Code w/Indiana Amendments
FOUNDATION TYPE:
construction a)
CRAWLSPACE
For Single Family and Two Family dwellings, additions, remodels, andlor amessory strucn
days of the date of issuance of the building permit, and must be completed (Certificate of
structure permits are subject to the General Administrative Rules of the State of Indiana
(Check all that apply for the new
O POST &
ISO
sl
and
1, the undersigned, agree that anconstruction, reconstruction, enl- emen :tlocstion, or altCML fin iey se of land or st:ucrures
any 4 ?
reeuested by this application will comply with, and conform to, all applicable laws of the State of hum . n t c "Zoning A f3rmel Indiana -1993' (Z:
289) and amendments, adopted under authority of I.C. 36,7 et seq. General Assemblyof the State of Indiana, and all Acts atnendatory thereto. I further certify that only
kitch , bath, are floor drains are connected to the sanitary sewer. I further certify that the construction will not be used or occupied until a Certificate of
Oc pancyhas bee ued by the epartmentof Commmuty Senflces, yy-el, Indiana
signature of Owner or Authorized Agent Print Date
OFFICE USE ONLY: **xxxx*****xxxxxx***xxx*xxx*****xx*****xxxxxxxxxxxxxa<a=:==.._ -------------
Filing Fees:
INSPECTI UIRED:
Base Inspections: Charged Re
Upper Footi Lower g Under Slab T_ Reviews
Cert. of Occupancy: 5 5 V
Rough In Meter Fina ite J > 6 / O
P.R.I,F.: ? / r 1 Additional Fees
Cra;a lL-l?s?o? tv-q-o7 OT : 3ba..j0
Reviewed/Ap oved: Dept. of Community Services (Date) I i
S:Penntts/Fonns/ILP RESIDENT L Fee Recel bY: Date