HomeMy WebLinkAbout07100081 ApplicationI
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City of Carnre//Clay Township Permit #: I
RESIDENTIAL IMPROVEMENT LOC ION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER NAME: /? /J PHONE: FAX:
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RECORD:
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STREETADDRESS:
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_ BEST METHOD OF CT: sn- e, T,3 4
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PROPERTY NAME: PHONE: FAX: I'
OWNER: ? e- l.?S er hove-
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STREET ADDRESS: CITY: - - -
LOCATION LOT a: SUBDI'VI5?1yy?? ry?ryjME:
37 _ SECTION:
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INFO: ADDRESS OF CONTRUCTIGN:
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FOOTAGE:
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NAME OF UTILITY EXC ATION C NTRACTOR; PLAN COMMISSION (B / BPW DOCKET //? ? -
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT s'S (IF APPLICABLE): V r//5 L XC ?Vw/ r'V1
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FLOOD ZONE AREA DESIGNATION(S) ' p, b p
FORTH'S E AREA DE TAX MAP PARCEL s:
/ 7 - O JI -2,r- eo - 5'V- 00 7000
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT: PLUMBING CONTRACTOR:
SINGLE FAMILY NEW STRUCTURE /? 1191611.1 J/Ae
O TOWN HOME ? ROOM ADDITION(S) Plumber's Indiana State License #:
? TWO FAMILY ? PORCH ADDTTION(S)
? S/G 3
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# of units being ?? DECK ADDITION(S) 0 4
constructed at this ? REMODEL Which plumbing codes will be applied to the construction:
time: _ Basement Finish only
O RESIDENTIAL (For O ACCESSORY BUILDING International Residential Code w/Indiana Amendments
Additions, Remode Etc) O DETACHED GARAGE
ELEASE
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Uniform Plumbing Code w/Indiana Amendments
CTION
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PROJECT INFORMATb:'ect ?
o comDllan FOUNDATION TYPE: (Check all that apply for the new
ce with all regulations
Early Release Ot21 C?Q
S construction area)
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Permit: _f) OF j?
N " ? CRAWLSPACE ? POST & _ BEAM -PIER
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Lot Split: S.}7QF C'fRRY'n?i l ,Y?IES r SLAB ? EASEMENT (WALKOUT:_Y_N )
For Single Familyand Two Family dwellmgs, INUTAi ["odels, and%or accessory,itructures, this permit is valid only if construction commences within ISO
days of the date of is inerce, of the budding permit, and must be completed (Certificate ofoccupancy issued) within IS months of the issuance date. Class I
structure permits are subject to the General Administrative Rules of the State of Indiana (See 675 LAC 12) regarding expiration time frames for beginning and
completing construction.
1, the undersigned, agree that any construction, rewri,tmction, enlargement, relocation, or alteration of a struc.ure, or any change in the use of land nr strunures
requested by this application wil?comply with, and con_for:ntn, all applicable laws of the State of Indiana, and the'Loniug Ordinance of Carmel Indiana-199 (-
2391 aid annendtnenu adopted unth-.uthortty of LC. 36-7 ct seq, Gencrai As= mblc of the Stare of Indima, and all ACts amendatory thereto. I further terrify that only-
kitcheu, bath, and floor drains arc connected to the sanitary sewer. 1 It tther certify that the construction will not be used or occupied until a cerriBcare of
Occupancy has been issued by tl [meet of Community Scriwes, Carne . Ineltana .?1
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Signature of owner or Authortteii Agent Prim (late
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OFFICE USE ONLY:
INSPECTIONS REQUIRED: Filing Fees: 6! 7r: D
Base Inspections: -3 0 . 0 Charged Re-
Upper Footing Lower Footing Under Slab Reviews
Cert. of Occupancy: S
R n er Base Fin Site a / 71
P.R.LF.: lJ Additional Fees
TOTAL:
Re ed/AfawId " De L of Community Services (Date)
S:PeolFom1s/ILP I VEN71AL
/ nee Receivetl by: Date