HomeMy WebLinkAbout07120026 Application`?i u Wye}
?IYPIFII F-%:
City of Carmel/Clay Township
Permit #:(9RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER NAME: PHONE:
/7'S?.Q? F7/-7}37S=877
7
OF
RECORD: STREET ADDRESS: CITY: STATE:
'2j4
?-5
K ZIP:
G 2
P rI o
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BUILDER's EMAIL ADDRESS: BEST METHOD OF CONTACT:
PROPERTY NAME. PHONE: FAX:
5
3° -//
a
OWNER r D Y '
-
VE
:
STREET ADDRESS: CITY: STATE:
15-10 yIP?(r{ Dy JA - ZIP:
'160
LOCATION - LOT SUBDIVISION NAME: SECTION: ZONING: S^? -
& PROJECT
INFO: ADDRESS OF CONsTPucrION:
p Ih•e4 V5 r SQUARE
FOOTAGE:
SEWER UTILITY
PROVIDER: C (,(
III n
1? _11`4
/// WATER UTILITY /
PROVIDER: (( rAe I ESTIMATED COST OF CONSTRUCTION: L/ 1 O L)0
(EXCLUDING LAND VALUE) /
CA
NAME OF UTILITY EX CONTRACTOR; PLAN COMMISSION / BZA/ BpW DOCKET
TION
NUMBERS; TAC DATE(S); ANDIOR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE):
r
FLOOD ZONE AREA DESIGNATION(S) TAX MAP PARCEL #' I L
FOR THIS PROPERTY:
TYPE OF CONSTRUCTION;
O SINGLE FAMILY
O TOWN HOME
O TWO FAMILY
# of units being
constructed at this
time:
0 RESIDENTIAL (For
Additions, Remodels. Etc.)
PROJECT INFORMATION:
Early Release
Permit:
Lot Split:
Y N
Y ?N
TYPE OF IMPROVEMENT:
O NEW STRUCTURE
O ROOM ADDTYON(S)
O PORCH ADDITION(S)
O DECK ADD ION(S)
O REMO
Basement Finish only
O ACCESSORY BUILDING
DETACHED GARAGE
ATTACHED GARAGE
O DEMOLITION
Manufactured
Trusses: _Y N
Sump Pump: _Y _N
PLUMBING C NTRACT H U,L C 2 7 1111
?0 05-"&X Mbilt • Ll
Plumber's Indiana State L aJL•?___
ff/ 6}C5_?W6 oZ-
Which plumbing codes will be applied to the construction:
O International Residential Code w/Indiana Amendments
f I_ Uniform Plumbing Code w/Indiana Amendments
TFOUNDATION TYPE: (Check all that apply for the new
construction area)
O CRAWLSPACE O POST&
O SLAB ? BASEMENT (VIALKOIN
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this permit is valid onlwLhe 2nences within 180
days of the date of issuance of the budding permit, and must be completed (Certificate of Occupancy issued) within uance date. Class I
stricture permits are subject to the General Administrative Rules of the State of Indiana (See 675 LAC 12) regarding es for beginning and
completing construction.
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alteration of a structure, nd orstruct ures
requesud by this application will ccmply with, and conform to, all appLcablc laws of the State of Inciana, ant insnce of Carmel Indiana -1993" (Z-
289)and amendments,adopted undera=.rhority of l.C.36-7etseq, General Assembly of the State of indiana,an Il endatory thereto. I further certify, that only
kitchen, bath, and floor duns are connected to the sanitary sewer. I further certify that the construction will used or occupied until a Ccrnfcate of
Occupanct•has been issued by the Department of Community Services, Carmel, Indiana.
I
I ??° P i I 11 ?z -
cu.... rrw,. a?truriz m? Print Date
xxx****xxxxxx**xxxx*xxxx**xxx***x*x****x*x****x*xx***p*y?rx ?xxx**xx****x******
OFFICE USE ONLY:
Filing Fees: Jd
INSPECTIONS REQUIRED: # Charged Re-
Base Inspections: ??? ?Q Reviews
Upper Footing Lower Footing Under Slab
Cert. of Occupancy: S J -.rU
u h Meter Base Final Site
Additional Fees
P.R.I.F.:
n
1z
Reviewed/Ap roved: Dept. of Community Services (Date)
S:Peonas/FormylLP RESIDENTIAL