HomeMy WebLinkAbout07100090 ApplicationU <p? O
City of Carmel/Clay Township Permit #:
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
- solos?./ For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER NAME: PHONE: FAX: Y6 _ Yu
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OF
RECORD: STREET AODRES CITY: STATE: ZIP:
?YIGIt BUILDERS EMAIL ADDRESS: BEST METHOD OF CONTACT:
1115
ER ?ck
D a
PROPERTY NAME: PHONE: FAX:
OWNER:
eolr
STREET ADDRESS: CITY: STATE: ZIP:
LOCATION LOT #: SUBDIVISION NAME: C
?Z SECTION: ZONING
PROJECT , a n c e
&
INFO: ADDRESS OF CONSTRUCTION:
/
i
S
/ ?ti SQUARE
FOOTAGE: L 0/
d H C
/
47 y/
a v
SEWER UTILITY CT "t
PROVIDER: CJ/t ?? UTILITY
PROVIDER: K C STIMATED COST OF CONSTRUCTION: 4 V
(EXCLUDING LAND VALUE)
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET 10
y(jG?
?
NUMBERS; TAC DATE(S); AND(OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE): (
? Y• O w n
FLOOD ZONE AREA DESIGNATION(S) TAX MAP PARCEL #:
FOR THIS PROPERTY:
TYPE OF CONSTRUCTION:
SINGLE FAMILY
O TOWN HOME
O TWO FAMILY
# of units being
constructed at this
time:
? RESIDENTIAL (For
Additions, Remodels. Etc.)
PROJECT INFORMATION:
Early Release
Permit: _Y _N
Lot Split: _Y _N
TYPE OF IMPROVEMENT:
Q' NEW STRUCTURE
O ROOM ADDITION(S)
O PORCH ADDITION(S)
O DECK ADDITION(S)
O REMODEL
_ Basement Finish only
O ACCESSORY BUILDING
O DETACHED GARAGE
? ATTACHED GARAGE
O DEMOLITION
Manufactured 11_?
Trusses: Y _N
Sump Pump: 'Y _N
PLUMBING CONTRACTOR: I U ?FS1.?P?S
?? S S
Plu ers Indiana Ste a Licen
/'u C- ?I d 0.-
Which plumbing codes will be applied
?emational Residential Code w/Indiana Amendments
O Uniform Plumbing Code w/Indiana Amendment.
FOUNDATION TYPE: (Check all that apply for the new
construction area)
BEAM -PIER
![111UT:Y )
For Single Family and Two Family dwellings, additions, remodels, and/or accessory s[ructtps$tfiifpa2al{7t iSPlol{f f iTco ommences within 130
days of the date of issuance of the building permit, and must be completed (Cc jN*W I!¢5?t1(? bPETii'lssuance daze. Class I
structure permits are subject to the Genera] Administrative Rules of the State of la'Tie?a'(STE b7rig {??gltpjr?s for beginning and
completing tpt???C CARM?IV"1
1, the undersigned, agree that any construction, reconstmction, enlargement, relocar of alteation of a st?q ?i change in the use of land or strvctures
requested by this application wiP comply with, and confo.-:n to, all applinble laws of the State of Indiana, atH fhe onmg Chdinarce of Cannel Indiana -1993" (Z-
239) and amendments, adopted under authority o£I.C. 36.7 et see, General Assembly of the State of Indiana, and all Acs amendatory thereto. I furher certify that only
kitchen, bats. and Boor drains are connected to the sanitary sewer. I further certify that the construction will not be used or occupied until a Cerubeateof
Occu cyhas been issued b e Department of Community Services, Carmel, Indiana.
/v-/?"^07
ature of Ow?rer or AUthdi cot Pri Date
**xxxx******xxx*xxxxx*****x****x**xx:*x.***x**xx****::***x..x*x:;;***xxx**x********
OFFICE USE ONLY:
INSPECTIONS REQUIRED: Filing Fees: V
Base Inspections: # Charged Re-
Upper Footing ower Footing Under Slab 55 Reviews 50
I___ Cert. of Occupancy: r
ough In Meter Base Final Site /
P.R.I.F.: a 611 06 Additional Fees
TOTAL: S3 ?-T
Reviewed/App ved: Dept. of Community Services (Date) - l '•?
S:4nnitsiF S/IUP RESIDENTIAL Fee Received b':: Ddte