HomeMy WebLinkAbout07110046 Application;'4itiov cagy
City of Carmel/Clay Township Permit: 071
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
x For Single Family, Town Home, & Two Family: New Structuresr Additionsr Remodelsr & Accessory Structures
!NPIPMP ?'
BUILDER NAME.
01u'_r--R PHONE: FAX:
OF
RECORD: STREET ADDRESS: CITY: STATE: ZIP:
BUILDERS EMAIL ADDRESS: BEST METHOD OF CONTACT:
PROPERTY
OWNER: NAM`:
k&,JAI-O 0U956_6'(-- PHONE:
202? 17 35 FAX:
566 -f?SSC7
STREET ADDRESS:
/3o ?U?r'ANtc ??• CM: STATE:
CARhcZ -:;7-/L) ZIP:
X03 Z
LOCATION
&PRO]ECT LOT #: SUBDIVISION NAME: SECTION:
NC?R2? VILL/}G,L? ZONING:
k s
INFO: ADDRESS OF CONSTRUCTION:
Tao ?1?t???J ?2
?f7V E FOSQUARE
OTAGE: T
?g
SEWER UTILTfY ^ N
PROVIDER: WATER UTILM
PROVIDER: GA2N t L ESTIMATED COST )F CONSTRUClT0
(EXCLUDING LANG VALUE)??'?rD O
NAME OF UTILM EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / SPIN DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE):
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY: TAX MAP PARCEL #:
4 q ?1
-0 /'-O 000
TYPE OF CONSTRUCTION: .yy 1
O SINGLE FAMILY (NZyli r?d{
O TOWN HOME O
O TWO FAMILY
# of units being WI.IG1iaA1?
constructed at this PO1'61
time:
RESIDENTIAL (For
Additions, Remodels, Etc.)
PROJECT INFORMATION:
Early Release ./
Permit: Y _
Lot Split: _Y N
O NEW STUCfU RE
? ROOM ADITION
:
C
PORCH
O DECK ADDITIO S)
O REMODEL
_ Basement Fin
O ACCESSORY BUILDING
O DETACHED GARAGE
O ATTACHED GARAGE
O DEMOLITION
Manufactured
Trusses:
Sump Pump:
_Y
YX _2
For Single Family and Two Family dwellings, additions, remodels, andlor access,
days of the date of issuance of the building permit, and must be completed (Cet
structure permits are subject to the General Administrative Rules of the state of
N 1 G CONTRACTOR:
tJ
Plumbers a State License #:
91nm
Which
O
es will be applied to the construction:
Residential Code w/Indiana Amendments
bing Code w/Indiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area)
O CRAWLSPACE
SLA, eE?OV
BEAM -PIER
?q?ttcrs within 180
Ske date. Class 1
for beginning and
1, the undersigned, agree that any construction, reconstruction. enlargement, relocation. uz altcn999,,,gpp Or?`d r. t(yLTiar?ge in the use of land orstructures
requested by this application will comply with, and cunfom: to, all applicable la.r of -he sta?lZfEdfian?, fKdnce of Carmel lydiana-1993" (Z
289) and amendments, adopted under authority of I.C. 35.7 et sea., Genera Assembly of the S 1®ffin'.?'and all. Ythdrrtendatorr thereto. 1 furher cenfy that only
kitchen, barh, and Poor drains are connected to the sanitary sewer. I further certify that tb? s etion will not be used or occupied until a Certlfiate of
Occupancyhas been issued by tb epe_ ent of Commu ' Ise es, Carmel, Indiana.
Oug_?Fz-z__ 111-e9;7
signature of Ownero utharized Agent Print Date
OFFICE USE ONLY: xxx***********x **xxxx**x+* ***xxxx****x****x*****x**x*** *x*x*xxxxxxx***xx
Fees:
INSPECTIONS REQUI D: # Charged Re-
Base Inspections: S . 00 Reviews
Upper Footing Lower Footing er Slab
Cert. of Occupancy: 5 S-S4
ough In Meter Base P. R.I. F.: Additional Fees
Reviewed/A proved: Dept. of Community Services (Date)
Stress/rvnns/[lP RESIDef.T1AL Fee
tN:
oP_ Qo
Date