HomeMy WebLinkAbout07110106 Application_ VO /
City of Carmel/Clay Township l? Permit #:?1fa a6
RESIDENTIAL MPROVEME OCATI_ J, APPLICATION
For Single Family, Town Home, & Two Family: N tre`?, VIbns models, & Accessory Structures
BUILDER NAME
S oFrN?1?N? PHONE. FAX.
v 317-3 15--7516
OF
RECORD: STREET ADDRESS:
l CITY: , STATE: ZIP:
R/ 5i6 zo
?
i S .
18 E f A .a M
BUILDER'S EMAIL ADDRESS:
b
_ D OF CONTACT:
O
3i7- 3?-zo3Ll ?a,?
1 ,??
G
PROPERTY
OWNER: NAME:
Ierr D. ?4- /AIJ 5?1r PHONE: FAX:
31-7 -873-580 /
STREET AODRE?s:,
loSBS 1?? s G-t CITY: STATE: _ ZIP:
CArme,I .1N 't'032-
LOCATION
PROJECT LOT SUBDIVISION NAME:
3 W SE"ON:
ON E ZONING: 5-(
&
INFO: ADDRESS OF CONSTRUCTION:
?
rN ?lLo3Z SQUARE
OTE:
?aa
L (rne
/oS
&1 46-5 C,
SEWER UTILITY
PROVlDEft Lkj, WATER UTILTY
PROVIOER: G n ?•A? l
7 ,ESTIMATED COST OF CONSTRUCTION: i S
(IXCLllDING LAND VALUE) lJ /
v J (7
NAME OF UTILITY IX BPW DOCKET
VATI ONTRACTOR; PLAN COMMMON / BZA //
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #5 (IF APPLICABLE):
FLOOD ZONE AREA DESIGNATION(S) TAX MAP PARCEL #:
FOR THIS PROPERTY:
TYPE OF CONSTRUCTION:
O SINGLE FAMILY
O TOWN HOME
? TWO FAMILY
# of units being
constructed at this
time:
RESIDENTIAL (For
Additions, Remodels. Ebel
PR OJECT INFORMATION:
TYPE OFIMPROVEMENT-
? NEW STRUCTURE
O ROOM ADDITION(S)
? PORCH ADOMON(S)
O DECK ADDITION(S)
REMODEL
_ Basement Finish only
? ACCESSORY BunDING
? DETACHED GARAGE
O ATTACHED GARAGE
O DEMOLITION
Early Release / Manufactured
Permit _Y _N /Truss:
Lot Split: Y - Trusses: Pump:
PLUMBING CONTRACTOR:
Mumber's Indiana State License #:
Which plumbb codes will be
O International Resfdenl
O Uniform Plumbpnjonili
new
-Y -N
Y _N
Fur Single Family and Two Family dwellings, additions, rcm9drls, and/or aceessory
completed (C<rrffi
days of the date of issowce of the building permit, and most he
stroemer hermits ..,object to the General Administrarive Ruler of the State of Ind a 675 L
completing coosrruetion-
I, the undersigned, agree that any construction, reconstrvctlon, enlatgemen4 relocation, or 2heradoo of a
requested by this application will comply with, and contour to, all applicable laws of the Slam of lndiana
289) and amendments, adopted under authority of I.C- 36-7 et scq, General Assembly of the State of Indian
kirchen, barb, and Uovr drains are connected to the sanitary sewer. I further certify that the cons
a.
fkcupw ,,has bjkissmd by the Department of Community Services, Carmel. Indin
not
oWirummences withiD 180
k issuance date. Class I
hamesfor begmnirrgand
use of land or structures
??ttnne! lutlima -1993" (Z-
. further remfy that only
until a ?rrdBcarc of
E
USE ONLY:
INSPECTIONS REQUIRED:
pper Lower Footing er Sla
Rough In Meter Base final Site
Caaaa tsv r I1-28 a7
Reviewed/ rnved: Dept. of funRTRarity Serv)ms (Date) T
S:PaTr ts/Fom,s P RFSIDENTLAL
/1-/
Filing Fees:
00 evved Rr
Base Inspections: Revie
t+s
Cert. of Occupancy:
P.R.I.F.: Additional Fees
TOTAL: o) , eO
byr.