HomeMy WebLinkAbout07100215 Application?a..4
City of Carnfel/C'lay Township Permit #: 10(2 5/
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
CMOI>w?.%' For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER NAME: PHONE: FAX:
35
f7-28 -!970
M S-2 S-SIC I
Z
OF UR
RECORD' STREET ADDRESS: CITY: STATE: ZIP:
I I C Ic r L 6 a t_ y 603L
BUILDER'S EMAIL ADDRESS: BEST METHOD OF CONTACT: ZbS-2-2-4'1
b S• r?ueC Al m?¢1CJ4 , CD&i, r, 9D2-22
PROPERTY NAME: PHONE: FAX:
OWNER: ZLr E)?_ 3f7 2s - a4 8 S4s!
STREET ADDRESS: CITY: STATE: ZIP:
III SnLie- L C' 204E L 516032-
LOCATION LOT": F f SUBDIVISION NAME: SECTION:
azwe
D STl<I< ?S Tes SvcI>aAT S ZONING:
S '?
PROJECT -
&
INFO; ADDRESS OF CONSTRUCTION:
' SQUARE
FOOTAGE:
17 6 6
P.,ob1?EG ST1L.lL LA0 E
(1 f ?S C
SEWER UTILITY WATER UTILITY ESTIMATED COST OF CONSTRUCTION:
PROVIDER: 5EP-n? PROVIDER: E LL_ (EXCLUDING LAND VALUE) 300
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATECS); AND/OR COUNTY WELL AND/OR SEPTIC PERMrT as (IF APPLICABLE):
lr--x T? Fe n "I
FLOOD ZONE AREA DESIGNATION(S) t
TAX MAP PARCEL q:
FOR THIS PROPERTY: X
U 1.1 u o yvv v
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT: PLUMBING CONTRALTO
O SINGLE FAMILY ? NEW STRUCTURE '
? TOWN HOME -ip RE1981"ADDITION(S) Plum-bees Indiana State UC
O TWO FAMILY ? PORCH ADDITION(S)
# of units being ? DECK ADDITION(S) / -
constructed at this ? REMODEL which plumbing codes will be applied to the construction:
time: _ Basement Finish on
7; RESIDENTIAL (For ? ACCESSORY BUILDING 0 International Residential Code w/Indiana Amendments
Additions. Remodels. Etc.) 109 DETACHED GARAGE Uniform Plumbing Code w/Indiana Amendments
O ATTACHED GARAGE O
a ./?DEM ION
PROIEC7INFORMATION: ?((J p P FOUNDATION TYPE: (Check all that apply for the new
L`1?.Yif"'t 114, construction area)
Early Release //' M red
Permit: _Y'_N Trusses: _Y _N C CRAWLSPACE ? POST & _ BEAM -PIER
Lot Split: ._Y ?_?Sump Pump: _Y _N SLAB n BASEMENT (WALKOUT: Y N )
For Single Family and Two Family dwellings, additions, remodels, andbr accessory structures, this permit is valid only if construction commences within 160
days of the date of issuance of the building permit, and must be completed (Certificate of Occupancy issued) within IB months of the issuance date. Class 1
structure permits are subject to the General Administrative Rules of the State of Indiana (See 675 I AC 12) regarding expiration time frames for beginning and
completing construction.
I, the undersigned, aree that any construction, reconstruction, enlargement, relocation, or alteration of a structure, or any change in the use of land o, structures
requested by this application wilt comply with, and confo-nn to, all applicable laws of the State of Spfdi[[ tf3N, 61 CMrt tJ Ifl? diana -1993" (_
2P,9) and amendments, adopted under authoriy of LC. 35-7 e[ seq, General Assembly of the State f InQt+n?J ViZAo1 -'?j¢nt?alpSy?tt(eretti"I exher certfy that only
kitchen, bath, and Door drains ate corrected to the sanitary sewer. I further certify that the con c not ?e use3 oroccupied untila Cern&cateof
OccrtoancvIras been issued by thp.BepAgment of Community Services, Carmel, Indiana
i w >`- 41 {DMAS M' iueeL. 10.30•b7z
Ownerer AuMo Vent Print Dale
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OFFICE USE ONLY: *"***acts:ssss*zzzsszt*t*>ka*..Filing*rsssFees: :ssx::.s::r?._// .=fiY
?s? DNS REQUIRED:
? Base Inspections: 70? U
: Upper Footing ower Footing Under Slab
Cert. of Occupancy: Q
Rough In eter Base real Si 6
P.R.I.F.:
TOTAL: t'a a, a?
/ApprovcrC ' ept. of Community Services (Date) ray`„ n ?
U a
J I Reviews
u/o
t Addition I Fees `
rsse??y?s•i.
541.I
S:?WForms/10 RSiDEWIAL