HomeMy WebLinkAbout07100011 Application:c ?Stic
City of Carmel/Clay Township Permit #: )l
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
F,eolE7.?./ For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER NAME: PHONE: FAX:
OF G/L F
RECORD: STREET ADDRESS: CITY: STATE: ZIP:
137 z-a evvrzz- e4aoT . 3
BUILDER'S EMAIL ADDRESS: BEST METHOD OF CONTACT:
AQd i ?k i1 a r..sn. c.., c,p -50?k ' 40 ) '?
PROPERTY NAME: PHONE: FAX:
OWNER: /L T- i>
STREET ADDRESS: QTY: STATE: ZIP:
3 GI a4Ie-cpym- ,-oozrr- ' ,arz nL- rv _:?" -f-:,
LOCATION LOT:: SUBDIVISION NAME: SECTION: ZONING:
& PROJECT MO-e- "A"
INFO: ADDRESS OF CONSTRUCTION: ???.13t FOOTAGE: 6 L
I I
377 16'J2/Ce- ,4-T-
e Q,U 2 7r
-mi? L aN .
O
SEWER UTILITY WATER UTILITY ESTIMATED COST OF CONSMUCTIO(J:
UE
PROVIDER: L (? PROVIDER: \\1 1 (EXCLUDING LAND VAL
) '1915 q 00
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COM D
IF APPLE
'S
1
/
(J?T 1 V
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR ( _
L ??? V
T
1 /
H
FLOOD ZONE ARRE DESIGNATION(S) 11 (l CC? ' ?+ TAX MAP PARCEL r:
TYPE OF CONSTRUCTION:
SINGLE FAMILY
TOWN HOME
0 TWO FAMILY
# of units being
constructed at this
time:
0 RESIDENTIAL (For
Additions, Remodels, Etc.l
PROJECT INFORMATION:
Early Release
Permit:
Lot Split: _Y _)( N
TYPE OF IMWOVEMENT--_,??_' PLUMBING CONTRACTOR:
X NEW
O ROOM A ITION(S) Plumbers Indiana tate License
PORCH AD( )S) ti r r? 1 T ?? J QJ
O DECK ADDrTIONITIONS '? 1/LZY1fE'-1 1) J !)G1L
O REMODEL which plumbing codes will be applied to the construction:
_ Basement Finish only
CJ ACCESSORY BUILDING O International Residential Code w/Indiana Amendments
O DETACHED GARAGE ATTACHE RA Uniform Plumbing Code w/Indiana Amendments
Ci ?aI
DEMOLITIO LL FOUNDATION TYPE: (Check all that apply for the new
Manufactured ?f? construction area)
Trusses: ?,Y IV{fie' 0
Sump Pump: Y _N 161316 L?
nCl T-f
For Single Family and Two Family dwellings, additions, remodels, and/or accessory strut
days of the date of issuance of the building permit, and must be completed (Certificate i
structure permits are subject to the General Administrative Rules of the State of Indiana
-MM -PIER
5
_Y-)< N )
thin 180
Class I
king and
I, the undersigned, agree that any construction, reconstruction, enlargement, =elocation, or aft( fulif4e ise, or; g the use of land or structures
requested by this application will comply with, and conform to, all applicable laws of the State o`t'firdiana, arcthe_?oriA tiarce of Carmel ir_diana-1993" (7-
289) and amendments, adopted under authority of I.C. 367 et see, General Assembly of tie State of Indiana, and all Acts amendatory thereto. I further certify that only
kitchen, bath, and floor drains are connected to the sanitary sewer. I further certify that the construction will not be used or occupied until a Certificate of
Orcupan hhals bee issueedd by he Department of o unity services, Carmel Indiana 1
L_?c1 YY-' 5 b D a N?f tk IJ ]a'
signature of Owner or Audwria Agent Prim - Date
OFFICE USE ONLY:**************** **xxxxx* *x*** x***xxxxx****x*xx*******:* ****x*xx*xxx*x*******
INSPE R€QUIRE Fill Fees:
b e Inspections: # Charged Re-
U oting Lower Footin der la U /I Sv Reviews
ert. of Occupancy: J J ' Q
Rough In Meter Ba inal Site
P.R.I.F.: Z.2 6 z (70 Additlonal Fees
(:?f4_'1 10-11-07 TOTAL: a dx
Reviewed/A proved: Dept. of Community Services (Date) ?. ,,? 1 r l,/ . 1 b f !? j
S: CereNts/FOrms(iLP RE4CEtffIAL Fee Retelve DY: t r 't `- T Date