HomeMy WebLinkAbout07100042 ApplicationPermit #: ?-7DOO1
_ City of Carmel/Clay Township -
RESIDENTIAL IMTROVEMENT LOCATION PERMIT APPLICATION
?!xsu+!b? For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER
OF NAME. PHONE:
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RECORD: STREET ADDRESS: aT-Yr:- STATE:
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BUILDER'S EMAIL ADDRESS: t4fn l"CAsf a'S'Ivlr{?t['r'r><'{y BE METHOD OF CONTACT: ,
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PROPERTY NAME: PHONE:
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OWNER: v
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STREET CITY:
LD??lo?o F. v7? ? .#4o0 STATE: / .? ZIP:
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LOCATION LOT SUBDIVI ION NAME: SECTION: ZONING:
& PROJECT b2:r2e
INFO: ADDRESS OF CONSTRUCTION: SQUARE
FOOTAG'E: r-%
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PROVIDER //))
ROVIDER LITI' (EESTIMATED COST XCLUDING DOVALONSIRUC 710N ?. LIU
:
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT k'S (IF APPLICABLE):
W 11 S?y? ?,M-3PXt
FLOOD ZONE AREA DESIGNATION(S) TAX MAP PARCEL #:
FOR THIS PROPERTY:
TYPES OF CONSTRUCTION:
9t SINGLE FAMILY
D TOWN HOME
D TWO FAMILY
# of units being
constructed at this
time:
? RESIDENTIAL (For
Additions. Remodels. Etc.l
PROJECT INFORMATION-
Early Release
Permit: _Y
Lot Split: Y _N
For Single Family and Two Family t
days of the date of issuance of the
structure permits are subject to the
TYPE OF IMPROVEMENT:
9'NEW STRUCTURE
? ROOM ADDITION(S)
D PORCH ADDITION(S)
? DECKADDITION(S)
? REMODEL
_ Basement Finish only
D ACCESSORY BUILDING
D DETACHED GARAGE
? ATTACHED GARAGE
? DEMOLITION
Manufactured
Trusses:
Sump Pumg;,
PLUMBING CONTRACTOR:
Plumber's Indiana State License
R1DUq S No
Which plumbing codes will be applied to the construction:
6d Intemational Residential Code w/Indiana Amendments
O Uniform Plumbing Code w/Indiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area)
K.T:S0v 0 9 0
regarding expiration
_ BEAM -PIER
_Y_ZN )
act1dhJ=nncnces within 180
of a, ance date. classI
1, the undersigned, agree that .y consttYir?t'y'r ?9? ?"e+lk?;e? ie t, relocation, or alteration of a ?4UEr v-ao-anY haty3 h N,Iand or structures_
requested by this appbcation will comcyFtiof I conform tq lawa of the State of Indiana, ante rhe'conmg l7rdinance?rmel Indiana -1993 (e-
289) and amendments, adopted under authorit of LC. 367 et metal Assembly of tie State of Indiana. and all Acts amendatory therein. I furher certify :hat only
kitchen., bath, and floor drains are conpp cre4 to the sanitary sewer. I further certify that the construction will not be used or occupied until a Cera6cate of
VD- 41:? __d'7
Date
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INSPECTI S REQUIRED: Filing Fees: U
Base Inspections: SO # Charged Re-
Upper Footin Lower Footi Under Slab Reviews
Cert. of Occupancy:
ough In titer Base nal Site
P.R.I.F.: ? ll ? U Additional Fees
GvdL 4 /mildsn? 10-9 -'z57 (tea
Reviewed/A roved: Dept. of Community services (Date) !/ L
S, a ftWForm;RtP RESIDENTIAL Fee Received b,:
Date