HomeMy WebLinkAbout07090150 Application. City of Carmel /Clay Township
Permit #: 0 ?iJ! ll , m
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER of MBE PHONE
? FAX
RECORD J '
:
STREET ADDR CITYrT STATE
(0 k ZIP
BUILDER'S EMAILADDRESS BEST METHOD Of CONTACT:
PROPERTY ME PHONE FAx
OWNER: 5
STREET ADDRESS QTl` STATE ZIP
LOCATION LOT # SDBD VIEEON NA SEC ON ZONING' p
& PROJECT
INFO: N51RUCVION
ADDRESS OI
=
M SQUARE
-
Fn
? FOOTAGE _ _
SEWER UTILITY ' kovjQ \,,vI WATER UTTLTTY ESTIMATED COST OF CONSTRl1C710N:
PROVIDER: C
`` ', `?S-` ' S'
KI
I PROVIDER: l rt U (ExCLUDING LAND VALUE) 131
rry [RVATION
NAME OF Lm
coNNTRACT
OR; PLAN COMMISSION I BZA / BPW DOCKET
NUMBERS; TAC GATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT es (IF APPLICA9LE):
TYPE F CONSTRUCTION:
SINGLE FAMILY
0 TOWN HOME
0 TWO FAMILY
# of units:
O MULTI-FAMILY
# of Units:
O RESIDENTIAL (For
^ LAJl
Additions, Remodels, Etc.)
Early Release
Permit: Y ?N
Lot Split: _Y ? N
TYPE OF IMPROVEMENT:
M' NEW STRUCTURE
0 ROOM ADDITION(S)
0 PORCH ADDITION(S)
0 REMODEL
0 ACCESSORY BUILDING
0 DETACHED GARAGE
0 ATTACHED GARAGE
0 DEMOLITION
Manufactured
Trusses:
Z
Y N
Sump Pump: J
/
ICY N
accessorystructureste oermitisv i t
he completed (Cer[ificRca[ of Occupa ^ ? m 9 Pn?
stra[ive Rules oRhe Slate of Indiana b751AC 13) regar ing
Does any part of the property lie within a special Flood designation area: _Y 1'?N WALKOUT:_Y V? N
For Single Family and Two Family dwellings, additions, n
within ISO days of the date of issuance of the building ple
issuance date. Class I structure permits are subject t FC
time s!
L the undersigned, agree that any construction, reconstro '
stiucmres requesed by [Lis application will comply with, and
Indiana-1993"(Z-? 59) and amendments, adopted under auto:
thereto. I huther txrtifvt t only kitchen,ba[i, a Apt, t.
v or occupied until a Cer cate ofC cupan as eett
OCT
Sig?a or Own uthorized Agent
OFFICE USE ONLY:************
INSPECTIONS REQUIRED:
Upper F n9 Lower Footing Under Slab
Rough [ titer Ba a Final Site
?4C_ • WV
RevieweiVApproved: Dept. of CCmmumLy Services (Date)
s:Pe.m'?wrwmslttr RESIDUMAL
d completing construction-
arioq or alCerst'onof astructure,t 1`viYYtgB [n:[h?u?{Id?Ilan?
able lams of the State of Indiana,' . d the "Zoning Ordinance of
?General Assembly of the nC3[e -ana, and all Ac[s amen
nirary sewer. i Further certi
of Community Services, C
armel, , Indiana.
PLUMBING CONTRACTOR:
C5 1L^ ? °' lies v?,
Plumber's Indiana State tense #: J
Which plumbing codes will be applied to the
O International Residential Code w/I
LJ Uniform Plumbing Code w/Indiana Amendmenfff'k -Wi
(Multi-Family Construction Code) lTga?
FOUNDATION TYPE: (Check all that apply for the new
construction area)
Irv CRAWLSPACE L7 POST & BEAM
0 SLAB ? BASEMENT
F?iP y1V1\5
Date
Base Irf%d
Cert. of O
P.R.I.F.:
F?e Received Cv:
i
rF Charged Re-
Reviews
rs-so
o6 Additional Fees
TOTAL: 6 /U