HomeMy WebLinkAbout07090141 Application4th cs ?Aek\
City of Carmel/Clay Township Permit: D
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
„01GMp j For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER
OF NAME,
vh PHONE:
l/ (317' 9"f?-77U?7 FAX:
c?l7`
773 3
RECORD: STREET
-6
y10 2 C1TY: STATE` ZIP'
3y
-
0 L_
CA ILDER'?MAIL ADORE
2Z4x
N0 BEST METHOD
1Z 8/ONiACT
S
l
PROPERTY
OWNER NAME,
SLP? PHONE:
3) 7 -g46-770c) FAX:
S
c.?
:
STREET ADDRESS: ITY: STATE:
C ZIP:
LOCATION LOT 5. SUBDNISION NAME: `?
c '1
J(,t,bptd Ivi s" 00 SECTION: 20 NG: '
1
PROJECT
&
INFO:
ADDRESS OF CONSTRUCTI :
7
I ?S
h
SQUARE
/
FOOTAGE: f 3z O
b
5
SEWER UTILITY
PROVIDER: WATER UTILSTY /`ll 1
PROVIDER; W eh ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE) I
000`
NAME OF UTILFTY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET r
OR SEPTIC PERMIT "(IF APPLICABLE): F
WELL AND
a .s .
/
NUMBERS; TAC DATE(S); AND/OR COUNTY
ijAL i
FLOOD ZONE AREA DESIGNATION(S) TAX MAP PARj[0
I I
FOR THIS PROPERTY: O 9 7
i
TYPPE?OF CONSTRUCTION:
yy 4INGLE FAMILY
G TOWN HOME
O TWO FAMILY
# of units being
constructed at this
time:
O RESIDENTIAL (For
Additions. Remodels. Etc.1
PROJECT INFORMATION:
Early Release
Permit: _Y /N
Lot Split: _Y,?rv
TYPE OF IMPROVEMENT:
CB" NEW STRUCTURE
O ROOM ADDITION(S)
O PORCH ADDITION(S)
O DECK ADDITION(S)
O REMODEL
_ Basement Finish only
ACCESSORY BUILDING
O DETACHED GARAGE
O ATTACHED GARAGE
O DEMOLITION
Manufactured
Trusses:
Sump Pump:
_Y -_?'N
_ Z_N
PLUMBING COQ OR:? r ??I
?be C Li
Plumbers Indiana State License #.
'fto bG )9 (o bb0(A
Which plumbing codes will be applied to the construction:
CD International Residential Code w/Indiana Amendments
Uniform Plumbing Code w/Indiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area) , A OT0
.(7) TC?1R$Vj?6Q?y/0tA$13 - W GEPkll1D0%E/AM -PIER
t_1 FPI`.SUkavli,?G?BA'FMEPLd68ALKDy?:Y_N )
strns, th?tliim?ntbr`Ees wuutm 180
For Single Family and Two Family dwellings, additions, remodels, and(or accessory
days of the date of issuance of the building permit, and must be completed (Certificate of Occu / m sl}nLy''f(h dL?MP issuance date. Class I
structure permits are subject to the General Administrative Rules of the State of Indian 12k non time frames for beginning and
complering construcu n(?F (.a r% "?-?{? NP
h the undersigned, agree that any construction, reconstruction, enlargement, relocation., or nlfi a structure, OQAa nge Li the use c' land or strictures
requested by this application will comply with, and conform to, all applicable laws of the State.a mchmm,'abd the'Zomng Ordinance of Car^ nel Indiana -1993" (L
289) and amendments, adcpted under authoriri of I.C. 7 et seq, General Assembly of the Stare of Indiana, and at! Acts amendatory thereto. I further certfy that only
kitchen, bath, amd oar drains are connected to the Cry sewer. I further certify that the construction will not be used or occupied until a CertiL'care of
Occupancy has tssuedbv the e t
kA 3-kQeA) 2 24 of mmunity Services, Cannel, Indiana. // ,?rte
Sip ie of Owns or Authorized Agent Print Date
*******x*****x****xxx*x*x*****xx******x*xxxxx****x?***xx**xx*****xx*xx***iaxx****x
OFFICE USE ONLY:
NSPECTIONS REQUIRED: Filing Fees: ?1 1 1 r
Base Inspections: # Charged Re-
Upper Footin wen Footing nde a Reviews
Cert, of Occupancy: s5 5n
Rough In eter Base Final Si
- P. R.I.F.: J '^ - Additional Fees
lW ?D-CJ?
Revieweviewed/Ap /Ap roved: Dept. of Community Services (Date)
S:PermiWFornvvI P RESIDEM AL Fee Recelved by:
Date