HomeMy WebLinkAbout07090105 Application`?V N• t+A? / /?
?,74t 'City of Carmel/Clay Ta"ship Permit #:
RESIDENTIAL EVIPROVEMENT LOCATION PERMIT APPLICATION
,o,anr. For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER NAME: PHONE: FAX:
OF 3 d c
RECORD' STREETADDRESS: CrfY: x K.f? STATE:
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g r zip:
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HUILDEWS EMAIL ADDRESS: BEST METHOD OF CONTACT:
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PROPERTY NAME: PHONE:
OWNER I /v
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SfREETADDRESS: F
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CTTY:
LOCATION LOT#: c? SVSDIVISIONNAME:/ SE DN:
PRO]ECT
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INFO.: ADDRESS OF CONSTRUCTION: /
? SQUARE
FOOTAGE:
s
C C !L
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SEWER UTILITY
PROVIDER: 4-) ro WATER UTIU-N ?
PROVIDER: ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE) ??
Il a (JOT -` ?
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION 1 BZA / BPW DOOT T
NUMBERS, TAC DATE(S); AND/OR COUNTY WE LL ANDIOR SEPTIC PERMFT #'S (IF APPLICABLE):
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY: V 1 O
*=07U TAX MAP PARCEL :',
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e
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F CONSTRUCTION:
TYPE TYPE OF IMPROVEMENT: PLUMSING CONTRACTOR.
NGLE FAMILY
SI I_ NEW STRUCTURE L- 4 A'
? TOWN HOME
? TWO FAMILY ? ROOM ADDITION(S)
? PORCH ADDITION(S) Plu tber's Indiana State License #: I
?
_ Do 3a--
# of units being ? DECK ADDITION(S)
constructed at this ? REMODEL which plumbing codes will be applied m the construction:
time:
? RESIDENTIAL (For _ Basement Finish only
? ACCESSORY BUILDING J
[ -6temational Residential Code w/Indiana Amendments
Additions. Remodels. Etc.) ? DETACHED GARAGE ? Uniform Plumbing Codew/Indiana Amendments
O ATTACHED GARAGE
PROJECT INFORMATION: ? DEMOLITION FOUNDATION TYPE: (Check all that apply for the new
construction area)
Early Release
N
P
i
Y Manufactured
N
Trusses: Y $? g
otbEAM PEER
? CRAWLSPACE Ll
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t: ?= (A
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Lot Split: _Y N Sump Pump: N -
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For Single Family and Two FamilydweElings, additions, remodels, and/ax accessorys t?ru??tgt_ ccs} _es witltirt 180
'te
Class I
F
GtYI
.,
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t
days of the date of issuance of the building permit, and must be completed (Cer[ificat P[Rcup?t97 ,,
structure permits are subject to the G
and
eneral Adrainistratwe Rules of the State of Indiana (see 675 L4G1 eti ouAnS
(j?
completing constrnctlgn? f 1
I, the un ersiprred, agree tint any constriction, reconsteue:ion, enlargemerr, relocation, n_ al*.dFa i n ?t1 - ''c a?gn the use of land ox stn:rmres
requested by tF is applicarion w,-11 carnplywith, =6conform to, allappl: cable lows o€:he sta n i Ms. the"Z SON of Carmel lnciar•a-1993"(Z.-
2R9} and arendments, adupred under authoCi[y o[ LC, i6-7 et ;eq, General Asseably of [':re State of Indtaoa, and all Acs amendatory therein. 1 Euc.',zer cetti[y that only
Wtcl,o, barh, aid floor &sms are coarected to the sanitary sewer. I further certify that the construction will not be used or occupied until a Ce L6 are of
Oczup?ancy%has been tssu yy Depunnent of Community Services, Carmel, Indiana.
%?- ? !??L?ty _C• fi ire
Siq rent 0.n o. AUtnorizea 16.3t Print ate
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OFFICE USE ONLY:
INSPECTIONS REQUIRED: Filing Fees:
Base Inspections: 6 # Charged Re-
ower Footlhig Under Slab Reviews
Cert. of Occupancy:
oug h Meter Base Final Site
P.R.I.F.:
Reviewed/Apprt Dept. of Community Services {Date} ?? i
S?Peaa?ts/rromiylLP RLStDemTAt Fee Recelved by:
?/• ?V Additonal Fees
3-
Date