HomeMy WebLinkAbout07100114 Application?.•.,.. a , Permit #:0 ! 1'00 Vt
City of Carmel/Clay Township
( RESIDENTIAL RVIPROVEMENT LOCATION PERMIT APPLICATION
Na Fwp / For Single Family, Town Home, & Two Family; New Structures, Additions, Remodels, & Accessory Structures
BUILDER
OF A PHONE: FAX:
I I I I Ifl?4? G ?Z?
RECORD: STREET ADDRES: r CITY: STATE: ZIP:
W Vr :car D I I C SC. , r f-? L4?00 -
2--BUILDER'S EMAIL DDRES?S7t.? BEST METHOD OF CONTACT:
BLW CJ I?-l?AwIG'-',
PROPERTY NAME: PHONE' r FAX:
l?t?t J S (Lt Ai -S76
H I tP 5 l? (Yva4 I O
OWNER: `
STREETADDRESS: C]TY: SATE: 'ZIP:
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LOCATION OT SU BDIViS[O E: SECT ON: ING:
& PROJECT
INFO: •NF •i".
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ADDRESS OF CONSTRUCTION:
S4UA
I„e -r FOOTAGE:
SEWER UTILITY
PROVIDER: ?? WATER lTR 7V
PROVIDER: f.ESFIMATED COST OF CONSiRUCT?„T .N:
{gZ DING LAND VALUE)
W lJ
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION Y BZA I B" Eif
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(ye AG
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NUMBERS; TAC DATE(S); ANDIOR COUNTY WELL AND/OR SEPTIC PERMIT :'S fI Lo711 _
OR THIS PROEA D SIGNATION($) MAP RCEL Y: }
F - -
TYPE eCONSTR I N: TYPE OF IMPROVEMENT: PLUMBIPm CTOR u ut, I A 0 i?DN/ U
f4 /
SINGLE FAMILY ? NEW STRUCTURE
? TOWN HOME ? ROOM ADDITION(S) Plumber's diana State Lic
? TWO FAMILY ? PO CH ADDITION(S)' -"'
1
# of units being ? CK ADDI770N
(5?) `?' t 4-
constructed at this ?
REMODELw'/rI GIL D' Which plumbing codes will be appliedmthe rnns[ruUiort:
time: _ Basement Finish only
? RESIDENTIAL (For O ACCESSORY BUILDING ? Intemational Residential Code w/Ind€ana Amendments
Additions, Remodels. Etc.} ? DETACHED GARAGE ? Uniform Plumbing Cade w/Indiana Amendments
ED ATTACHED GARAGE
PROJECT INFORMATION: CJ DEMOLmON
f
/
FOUNDATION TYPE: (Check all that apply for the new
construction area)
Early Release Manufactured f
Permit: Y
_
Trusses: _YNf 0 CRAWLSPACE C) POST II BEAM PIER
Lot Split: _Y _N _N
Sump Pump: _Y O SLAG O BASEMENT(WALKOUT:___Y_N)
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this permit is valid only if construction commences within 180
days of the date of issuance of the bmidung permit, and must be completed (Certificate of Occupancy issued)wahm 18 months of the issuance dace. Clasa I
structure pennits ate subject to the General Administrative Rules of the State of Indiana (See 675 IAC 22) regarding expiration time frames for beginning and
complctmg enmstoaction.
1, the undersigned, agree that my nmsnntrien, mmnstmction, enlargement. relocation, nr ahecatton of a scuctura o- any change m the use of lane crstruct ms
requested byrhis applicatiomwili comply wdth, and conform to. all amjchcabte laws of the State of Indiana, and the `Zomna Ordinattce of Carmel Indiana - INN (Z-
'furthercertify that only
3titchen, bacFr and 7oordrains am connected to the saritzrysewer. I further certify that the construrtion will not he nsed or occupied until a Certr6eate of
Occupancy a)been is ued 6? the Department of Community Services, Carmel, [udiana.
[in,laA,wn! nwrw, or BufMeimd deevtt Print DPW
OFFICE USE ONLY: ****xzzs**************xx***r*x*xxxxxxxx xxxx?xr=s?:::__i*=--=={-------------------.
INSPECTIONS REQUIRED: Filirg Fees: 51" Sc
Base Inspecti0n5: 1'1Se 0 Q 1<' Charged Re-
Upper Footing Lower Footing Ugde!~Slab Reviews
--?\ Cert. of Occupancy: ?S 4
Meter Base ( Final Site
P.R.I.F.:
TOTAL:
Reviewed/Approved: Dept, of Community Services (Date)
S:pPnaagFo , s/ILP RESIDENTIAL
Fee
Additional Fees
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as D
Date