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HomeMy WebLinkAbout07090148 ApplicationtiYa l( ?sZ' Permit #: V _ City of Carmel/Clay Township +`:! RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION ?(AOr+?!`• For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures BUILDER OF NPME: ?ev? PHONE; FAX: Vivewu" \hc RECORD: EET ADDRES) CITY:- a Qax ??2 SLATE: ZIP: UJC)j 1 3 BUILDER's EMAIL ADDRESS: 1 f? BEST `METHOD OF CONTACT: PROPERTY OWNER: E' PHONE: D T? ick-C, CL?6 LSD IIIJ' STREET ADDRESS: CITY: ATE: ZIP: S lit EP LOCATION O7 #: SUBDIVISION , ? SEC IO : _ ? ZO NG: ?3 & PROJECT ?? 1 V?S O[DU I ?' O Ctt INFO: ADDRESS CONSTRUCTION: © L- J ?- 1 /; t nnT?,1•' M1!`lll °Il+a Q17 FOOT F-0OTAGE: + SEWER UTILITY PROVIDER: G? ?-? \ L 1\) - WATER UTILTTY _ PROVIDER: ESTIMA D COST OF CONSTRUCTION: 1 \? CLUDING LAND VALUE) 1 v v v NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSIONJ'BDPW { OCKEf- R`? CA OR COUNTY WELL AND/OR SEPTIC PP14S (IF APPL1 D q/^^`' I l? ax CJ A NUMBERS; TAC DATE(S ); AN / r r \ C? Kl - \ FLOOD ZONE AREA DESIGNATION(S) TAX MAP PARCEL >t: FOR THIS PROPERTY: TYPE OF CONSTRUCTION: OR: T TYPE OF IMPR0AM6II:?PLUMBING CONTRAC 1 ? - y r lY' SINGLE FAMILY NEW STRUCTURE > •®' ' -r Q(Y oc \)` K C. S ? ' O TOWN HOME ) O ROOM ADDITION( s Indiana State License #: Plumber O TWO FAMILY O PORCH ADDITION(S) . n ? • 5? # of units being O DECK ADDITION(S) 1 e? W ? D ? Constructed at this O REMODEL e Which plumbing codes will be applied to the construction: time: O RESIDENTIAL (For _ Basement Finish only O ACCESSORY BUILDING C?'Intemational Residential Code w/Indiana Amendments Additions. Remodels. Etc.) O DETACHED GARAGE 10 Uniform Plumbing Code w/Indiana Amendments O ATTACHED GARAGE PROJECT INFORMATION: O DEMOLITION FOUNDATION TYPE: (Check all that apply for the new area) construction "cTAO Early Release Manufactured ? ng fQ? ?/ PIER SS ? Y-/ N Permit: Y _N Trusses: BEAM - LSRAfiE ?t $6 L? CRAW _ Lot Split: _Y ?N Sump Pump: ?Y _N ? 6(lst 1 For Single Family and Two Family dwellings, additions, remodels, and/or accessoryh k?" Znces within 180 daps of the date of issuance of the building permit, and must be completed (CertihcS 'U4 4u 8 c7j a issuance date. Class 1 structure permits are subject to the General Administrative Rules of the State of Indiana (See I5 34 G% t a con time frames for beginning and completing , constrac Poi u:e tC`han' e in the use of land or structures 1, the undersigned, agree that any consmvction, r<cons[ruceoa, enlargement, ment, relocaciolation, o_ W. requested by this application will comply with, and conform to, all applicable law; of the St a, and the"? ing Ordinance of Camel indiana -1993" (L, 239) and amendments, adopted under authority of LC. 367 et sec, General Assembly of the to of Indiana, and all Ac-s amendatory thereto. 1 further certify that only kitchen, bath, and floor drains re connected m the -ritary sewer I further certify that the construction will not be used or occupied until a Cemficate of cupancyhas been "5sued b}• epaztment of mmuniq• Seri`s, Carmel. Indi 2N l ` ` ?V\\ 7 O Sig^.?tu of Own Au zed Agent Print Date *xxxx*xsxx*****x*x**x****xx*****x**xxxx**x*****xxx**x***xx? **xx**xx***xxxx*xxx** OFFICE USE ONLY: INSPECTIONS REQUIRED: Filing Fees: 3 ?O Base Inspections: # Charged Re- per Footing ower Footing U la Reviews Cert, of Occupancy: SS Ro g Meter Base Final Site ) Additional Fees P.R.I.F.: G)raL ah 10- q 07 TOTAL: Reviewed/Appr d: Dept. of Community services (Date) S:Perml?FOrmsliLP RE IDEM AL - Fee Received by' Date