HomeMy WebLinkAbout07120048 ApplicationiS0® 7d'
City of Carmel/Clay Township Permit:
RESIDENTIAL MPROVEMENT LOCATION PERMIT APPLICATION
noinna For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER
OF NAME:
?/V Dd u PNONE
1 : FAX:
S71/'/ . ! d'?o • a o 3
RECORD: STREET ADDRESS: CITY: STATE: ZIP:
2 -7
BUILDER'S EMAIL ADDR ESS: BEST METHOD OF CONTACT:
PROPERTY NAME' PHONE: FAX:
OWNER: e? S
STREET AD RESS: CITY: STATE: ZIP:
LOCATION
PROJECT LOT C: SUBDIVISION NAME:
Z?8 nil l/4t ?F d SECTION:
/ - ZONING
:
!U?' 0
&
INFO: ADDRESS OF CONSTRUCTION:
_ af A- L4 4'4 SQUARE G
FOOTAGE: O 707
SEWER UTILITY
PROVIDER: GT11„V ?
WATER UTILTTY? ?/ at
PROVIDER:
ESTIMATED COST OF CONSi RUCTION:
(EXCLUDING LAND VALUE) O J J
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE): /' ?
"9C / JN
ROOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY: TAX MAP PARCEL w:
b
TYPE
N:
E CONSTRUCTION:
SINGLE FAMILY
? TOWN HOME
O TWO FAMILY
# of units being
constructed at this
time:
0 RESIDENTIAL (For
Additions. Remodels. Etc-1
PROJECT INFORMATION:
Early Release /
Permit: _Y lee
Lot Split: _Y fGl?
TYPE OF,IMPROVEMENT:
5;?' NEW STRUCTURE
? ROOM ADDITION(S)
? PORCH ADDITION(S)
O DECK ADDITION(S)
O REMODEL
_ Basement Finish only
O ACCESSORY BUILDING
O DETACHED GARAGE
O ATTACHED GARAGE
O DEMOLITION
PLUMBING CONTRACTOR:
A09. 30cks_? w Gi s 2
Plumber's Indiana State Licen a #:
CC) v-C"e s7
Which plumbing codes will be applied to the construction:
O international Residential Code w/Indiana Amendments
( ?Uniforrn Plumbing Code w/Indiana A fnendments
for the new
Manufactured construction area)
Trusses: Y/J /CRAyS
iY IN (?y/??gV\`?
Sump Pump: I
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 (Cei
structure penis are subject to the General Administrative Rules of the State of
PIER
?N )
ruction commences within 180
s of the issuance date. Class I
time frames for beginning and
1, the undersigned, agree that any constmcdon, reconstruction, enlargC. relocation,, oralte {ru1-41"e, or-ATcTiiange in the use of land or structures
requested by this apphcatien will comply with, and conform ro, all applicable laws of the State of t a d the'Zoning Ordinance of Camel Indiana -1993' (2-
289) and amendments, adopted under authority of I,C, 367 et seq. General Assembly of the S,,r diana, sod all Acts amendatory- thereto. I further certify oat only
kitchen, bath, and floc; drains are connected to tie sanitary sewer I further certify that the construction will not be used or occupied until a Cerafic to of
Occuen issued the lJepartm n[of Community Services,C??Tana. A1,4
Signature of Owner or Authorized Agent Print D
OFFICE USE ONLY:.:************************************************** ****/*?** * y********:****+*
Filing Fees:
NSPEMCINS RE UIRED: rT
Base Inspections: - Sd * Charged Re-
Upper Footing er Footi I Under Slab Reviews
Cert. of Occupancy: SS ??
g in meter Base Final Site
Reviewed/App ved: Dept, of Community Services (Date)
S:PertNWFmmS/] 2ESIDENt L
Fee Received bY:
Additional Uu
/ds( aR•.