HomeMy WebLinkAbout07110076 ApplicationCity of Carmel/Clay Township Permit #: I tlb
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RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
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DER
V NAi PHONE: - I FAX:
30-31
RECORD: STREET ADDRESS:
l CI; CITY: STATE: ZIP:. ?
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He ?y BUILD R'S EMAIL DRESS:. /, OF CONT ?: r' (a R (j XT T
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PROPERTY
OWNER: NAME"
?•i•-l? PHONE: II
ILJI FAX: Nov 1s 2001
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ADDRESS:. CITY: A
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LOCATION LOT #: SUBDIVISION NAME: , /
//J t -60Y SECTION: ZONING
5-1
& PROJECT
INFO: DDRESS O CONSTRUCTION: SQUARE
FOOTAGE:
SEWER UTILITY
PROVIDER: L'
/hY `PRO D R ???G
/ ATED OF CONSMl[kCTION:
ES CLIUDINGCLAND VALUE) J f
NAME OF LMLrrY IX ATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
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NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE):
FLOOD ZONE AREA DESIGNA ON ) O /y?
W 11 TAX MAP PARCEL-.
FOR THIS PROPERTY:
TYPE OF CONSTRU ON: TYPE OF IM ROVEMENT: PLUMBING CONTRACTOR:
yrc?f SINGLE FAMILY 54 NEW STRUCTURE ,y fiL"ii(L'?/'
O TOWN HOME ? ROOM ADDITION(S) PI is Indiana State Licens
.
O TWO FAMILY ? PORCH ADDITION(S) e
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u
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# of units being O DECK ADDITION(S) V
?
1
Constructed at this O REMODEL Which plumbing codes will be applied to the constructio
time: Basement Finish only
O RESIDENTIAL (For _
O ACCESSORY BUILDING G International Residential Code w/Indiana Amendments
Additions, Remodels. Etc.) O DETACHED GARAGE Code w/Indiana Amendments
Pl
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if
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O ATTACHED GARAGE u
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n
orm
PROJECT INFORMATION: O DEMOLITION FOUNDATION TYPE: (Check all that apply for the new
construction area)
Early Release
Permit: Y ?N Manufactured /l
Trusses: _Y Y? N P05T,? BEAM -PIER
`O CRAWLSPACE 0
11
Lot Split: _YN Sump Pump: ?Y N +
Tom' gLpg fS(_RnG`?Ci)(
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For Single Family and Two Family dwellings, additions, remodels, and,br accessory su
days of the date of issuance of the building permit, and must be completed (Certifird
structurc permits are subject to the General Administrative Rules of the State of Ind&
completing constr&
1, the undersigned, agree that any construction, recons-ruc ion, enlargement, relocation, or
requested by this aoplication will comply with, and conform to, all applicable laws of the St
289) and amendments, adopted under authcri[y of C36-1 et seq, General Assembly of the
kitchen, and floor drai aze connected to a sanite_y sewer. 1 further certify that a..
within 180
e. Class I
NURCupied 'In the use of land or structures
y?'?t??t[ce oECarmel Indiana-1993-(7--
,aW. thereto. I further certify tha_ orgy
will cuntil a Certificate of
Occu }'has been iss b D t of Commumry Scmwes, Carmel, Indiana / p /
r
Signature of Own orA ' ea Agent Print Date
OFFICE USE ONLY: xxx,rxxxxxxxxaaxxxaxxxxxxxxxxxxaaxxxxx:xxxxxxxs*s*`xxxxsxxxxxxxxxxxxxxxxsxxxxxss*
Filing Fees:
INSPECTIONS REQUIRED: -'? --
* Charged Re
Base Inspections:
pp 71(Meter in wer Food U b Reviews
Ir Cert. of occupancy: ??.
R uBase Final Site
P.R.I.F.: / D C) Ad (Fees
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L - ' -"' e-y?- 1 M ,
C'ra;,a i?-tlse.r 1-0Z6-o7
Reviewed/ ed: Dept. of community services (Date)
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'u M/Form%ILP RES:DETMAL Fee Received by:
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