HomeMy WebLinkAbout07110044 ApplicationPermit #:Q
City of Carmel/Clay Township
RESIDENTIAL INIPROVEMENT LOCATION PERMIT APPLICATION
??aouvs,% For Single Family, Town Home, & Two Family: New St?ucturesss Additions, Remodels, & Accessory Structures
BUILDER NAME: FAX:
OF
RECORD: STREET ADDR !CITY: STAT E: ZIP:
BUILDER EMAIL ADDRESS: BEST METHOD OF CONTACT:
PROPERTY
OWNER:
CZ;
NAME, PHONE:
A ? F
STREET ADDRESS: ?J /?
?/ CITY::: STATE:
Y ZIP:
LOCATION
& PROJECT LOT x: SUBDT st NAME:
/77 SECTION: ZONING :
INFO: ADDRESS OF CONSTRUCTION: SQUARE
FOOTAGE:
Pi
SEWER UTILITY
PROVIDER: r V
_
? h'dATER UTILITY
FrmDER: ESTIMATED COST OF CONSTRUCT
(EXCLUDING LAND VALUE) ION:
i?l'Y1Cf r m
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION
AND/OR COUNTY WELL AND/OR SEPTIC
TAC DATE
UMB
RS
S
'S A?WL?ABP
(
N
E
;
); CC
FLOOD ZONE AREA DESIGNATION(S) X TAX MAP PARCEL S:
FOR THIS PROPERTY: -Tjtw 1
TYPE O ONSTR (ii:
SINGLE FAMILY
? TOWN HOME
O TWO FAMILY
# of units being
gotistructed at this
me:
RESIDENTIAL(For
Additions. Remodels, Etc.)
PROJECT INFORMATION:
Early Release f
permit: _Y '
Lot Split: Y _N
O NEW S1
ROOM i
O PORCH
DECKA
" _ Basement Finish only
O ACCESSORY BUILDING
O DETACHED GARAGE
O ATTACHED GARAGE
O DEMOLITION
Manufactured
Trusses:
Sump Pump:
Y>1 /N
_Y.,
Indiana State License
Which plumbing codes will be applied to the construction:
Inte nal Residential Code w/Indiana Amendments N
Uniform Plumbing Code w/Indiana Amendments ?p%(?/
FOUNDATION TYPE: (Check all that apgllonthe new
construction area) _,ax . _..o
-PIER
For Single Family andT s, llf?o fet acctssor}•stnctores'?hiYpenni Fs9atkt"o y-ueonsttucuo ees 11cnsn'1o?
pf`Y' .?tth,,aVii ?t? (Certificate of Occupancy issu?P?µ} c, 8 mon o i suence dace.. Cass I
clays of the date of issu
structure permits are subject Me Gene Admmts[ratiee Rules of a State of Indiana (See 67°c'+' e?{?iisst?ot?ti,Cge fiatnes for begin.ring and
Q
completing construction. 3+? ^^?? ("j{`\?cl``tt??,,T?,PjVt•?
I, the undersigned, agree that any corstruaion, reconstrucuen, enlargement, relocation, or altera[iot?ut•t?ft'e, or any chhha!'m the use of land or strurures
requested by this app6ation will comp! th, and conform to, all applicabh laws of the 5[a[e of Iadi and :he "Zoning Ordinance of Carmel Indiana -1993" (2-
239) and amendments, adopted unde- utf ?rity eE LC. 367 zt seq, Gentrl Assembly of [Le Scare of Indiana, and all Acts amendam_y thereto. [ (archer certify that only
kitchen, ba-i, and floor drains are nn ed to the sanitaq• sewer. I further certify that the construction will no[ be used or oaupied un[il a Certi&nte of
Occup has been issued b e e t of Community Services, Corm L Indiana.
.. .....e n....,e..,. •,aa on mcnr Da
********************s*****************************:** * ******:sssxss************
?FFICE USE ONLY-
INSPECTIONS REQUIRED: Filing Fees: (0
Base Inspections: a • ?? # Charged Re-
Upper Footing wer Footing Under Slab Reviews
Cert. of Occupancy: F?7)
Rough In Meter Base Inal Si
P.R.I.F.: •`__? Additional Fees
C?„es.2 ls_a_? 17-G-67
Reviewed/Ap roved: Dept. of Community Services (Date)
S:Perml[s/FO VILP USIDErc L