HomeMy WebLinkAbout07090146 Application4, ` Permit :
City of Carmel/Clay Township
1. ' RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER
OF NAME:
?CM?S 1 V PHONE: FAX:
311- -"IIpCO 31'I - -"I-1°}?
RECORD: STREET 1 AD CITY: STATE: ZIP:
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E;AIL ADDRESS:
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PROPERTY AME. PHONE: FAX:
OWNER: 4::OVAe- Cat' 0L?1
STREET ADDRESS: CRY: STATE: ZIP:
LOCATION _
& PROJECT LOT u: SUBDIVISION NAME: _
Li e- 11 SECTION:
e. Ti ZONING:
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INFO: ADDRESS OF CONSTRUCTION:
Z Q TLan & G--f - SQUARE
FOOTAGE:
SEWER UTILITY
PROVIDER: WATER UTI
PROVIDER:
1 n
C ESTiMA7ED COST OF CONSTRUCTION:
(E)(CLUDING LAND VALUE) "t \kGlt "
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NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / 8PW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND,?OR SEPTIC PERMIT #'S (SF APPLI?E3'??. 11 oL, 9- (\%0j V ?
FLOOD ZONE AREA DESIGNATION(S)
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1 TAX MAP PARCEL #:
FOR THIS PROPERTY: rii f9?
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TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT' PLUMBING CONTRACTOK::
C?? SINGLE FAMILY (21 NEW STRUCTURE j?-tl((? 1 )??j
O TOWN HOME D ROOM ADOIfIQN(S) Plumber's Indiana State License #:
O TWO FAMILY O PORCH AD?1ON(5) /1nrao 1(x,1
#of units being O DECK ADD ON(S) 1, AJ Lr \LJ""l
constructed at this D REMODEL Which plumbing codes will be applied to the construction:
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time: _ Baseme 1 only
O RESIDENTIAL (For "J ACCESSORY IL 2 International Residential Code w/Indiana Amendments
Additions, Remodels, Etc.) DETACHED G;ARA?EF?to e? ,CCISy
niform Plumbing Code w/ Indiana Amendments
DATTACHE RAGEJf
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PROJECT INFORMATION: O DEMO?PTC?O(3C['7"?C N TYPE: (Check all that apply for the new
tll cQri's '' o p/
Early Release Manufactured ?
oilvj r, , "moo! .,
Permit: Y ?N Trusses: _/Y C"?/t?lv,' I O POST &_BEAM -PIER
Lot Split: _Y v"N Sump Pump: Y -VVID1 .- ? ,pr,LAg^ O .18ASEMENT (VJALKOl1T:_Y_N )
For Single Family and Two Family dwellings, additions, remodels, andlar accessory stMures, tfs''Als,? yalid ant 180
pan rsst(eithinstsat(`Se C s I
days of the date of issuance of the building permit, and must be completed (Certificate of CRcu cy
structure permits are subject to the General Admhdstradw Rules of the State of Indiana (See 675IAC 12) regarding e t e fW la and
completingconstruction.
I, the undersigned, agree that any construction, reconstmciion, enlargement, relocation, or alteration of a structure, or any c fn 5kte+f;e ?f it dlof;{tiuc.
requested by tHs application wlll co:nph with, and cunfc-n to, all applicable laws of the State of Indiana, and the'Zonin9O once , t64A`d L 199
269) and amendments, adopted uaderau:hority of I.C. 36-7 e[ seq, General Assembly of the State of Indiana, an 62.] ACts am e, [Dry thereto. I further cettily t a only
kitchen, bath, aid floor 'drains are connected to the sanitary sewer. I further certify that the construction wdl not be used co upied until a Cerrificate of
Occupang-has been issue t Department o ommunity Services, Carmel, Indirana -
1 oy\ LYQX -?) Ci(\y\.ls 2 L-1
?...., ,.. ,.s n.,..e. e,An 71II41 Anent Print Date
)FFfCE USE ONLY:
Filing Fees:
INSPECTIONS REQUIRED: a 3 Q .6 o R charged Re-
Base Inspections: Reviews
Upper Foo ing Lower Footing Under Slab b
Cert. of Occupancy:
Ro Me er Ba Final' Site / ?_ P.R.LF.: 00 Additional Fees
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Reviewed/Approved: Dept, of Community Services (Date)
S:Per.iWFarm41H" RESIDENnA FEe
Data