HomeMy WebLinkAbout07100092 ApplicationPermit #: V 1 o? 0 1.-
City of Carmel/Clay Township
RESIDENTIAL EUPROVEMENT LOCATION PERMIT APPLICATION
%xa of / For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER
OF MME' ! !!
Vl? S t T? n) PHONE: FAX:
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RECORD' STREET ADDRESS: CITY: STATE:
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BUILD I'S EMAIL ADDRESS:
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Q BEST METHOD OF CONTACT:
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PROPERTY NAME: /
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PHONE: /
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OWNER: I
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STREETA RESS: TTY: STATE: `'/ZIP:
LOCATION LOTSUBDIVISION NAME:
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6 SECTION:
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INFO: ADDRESS OF CONSTRUCR? FOOTAGE: 7962
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SEWER UTILITY
PROVIDER: C KLA) p WATER UTLP1 , 1
PROVIDER: C't"'ti W'- MATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE) Z
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMIS Ibn?ZS -8PW DOCKET II
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND!OR SEPTIC PERMIT #'S (IF APPLICABLE): N Gn1j? ?,a,J .? // b? I ODo91
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FLOOD ZONE AREA DESIGNATION(S) TAX MAP PARCEL #:
FOR THIS PROPERTY:
TYPED CONSTRUCTION:
SINGLE FAMILY
O TOWN HOME
O TWO FAMILY
# of uniWtteSri? 11?
Additions,
TYPE OF IMPROVEMENT:
O N STRUCTURE
M ADDITION(S)
11 CH ADDITION(S)
LI KADDITION(S)
O DEL
20 I asement Finish only
1 2
t=_i A SSORY BUILDING
1 O DET HED GARAGE
HED GARAGE
Early Release ? Manufactured
Permit: _Y-N/ Trusses: _YYL_-N
Lot Split: -y- N Sump Pump: _Y N
For Single Family and Two Family dwellings, additions, remodels, and/or acct
days of the daze of issuance of the building permit, and must be completed (I
structure permfrs are subject to the General Administr tive Rules of the State
PLUMBING CONTRACTO
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Plumber's Indiana State License
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Which plumbs -codes will be applied to the construction:
O In ational Residential Code w/Indiana Amendments
Uniform Plumbing Code w/Indiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area)
O CRAVILSPACE
BEAM -PIER
_Y N )
ees within 180
date. ClassI
1, the undersigned, ag-ee that any constriction, reconstmcdon, enlargement, -elocation Wrltibd' ? hfy`hange in the use of land orstructures
ce of Carmel Indiana -1993' (Z-
requested by this application will comply with, and confcrm to, all applicable laws of the I t??7°?? tran
289)and amendments. adopted under au[hority of LC. 36 -7et seq,General Asscmbiyo t eo lydiana,anSaR. c sar:enda:or/thereto. lfurther certify that only
kitchen barn, 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
has been issued by ee Department community Servtces, CarmelIndiana. 1 l- Q
_-l ?? ?t t? J J ?a-? \J 151 0^1
signature of owner or Authorized Agent Print Dace
OFFICE USE ONLY: *********xs*****xx******xx*x*****x******xxxxx**xxxxx****xa.xx.fi==r.*.=}___?_••-
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Filing Fees:
INSPECTIONS REQUIRED: ections:
Ba
Ins 9 7
r? # Charged Re-
Upper Footin Lower Footing Under Slab p
se l
1 Reviews
Cert. of Occupancy:
Rough In eter Base Final Site
P.R.I.F.: / G?
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Additional Fees
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Reviewed/Ap oved: Dept. of Community Services (Date)
S:PermlWForms!ILP RESIDENTIAL Fee Re Ii dby: Date