HomeMy WebLinkAbout07120007 ApplicationQf?07
City of Carmel/Clay Township Permit #:ir)
RESIDENTIAL RVIPROVEMENT LOCATION PERMIT APPLICATION
«ofxM??% For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER NAME. PHONE: _
C(
C FAX:
OF ?
J
RECORD: STREET ADDRESS: ++ CITY:n , STATE:
11 ZIP:
1,13 ?6
BUILDER'S EMAIL ADDRESS: BEST METHOD OF C A
U
!I i` fr
PROPERTY NAME. PHONE: _
FAX. III
OWNER oll
: 7E:
v
ZIP:
STREET ADDRESS:
LOCATION Lay
LOT` SUBDIVISION NAME ON:
e
J
PROJECT 1 C
&
INFO: ADDRESS OF CONSTRUCTION: FOOTAGE.
SEWER UTILITY
PROVIDER:
f\ WATER LMLr1Y J
PROVIDER:
V ESTIMATED COST OF CONSTRUCTION: / ?.\
(EXCLUDING LAND VALUE) (LJ
r i ll u'
DOCCKE
T
NAME OF UTILITY EXCAVAT10N CONTRACTOR; PLAN COMMISSION J BZA / BPW
`
'
S (IF APPLICABLE):
NUMBERS; TAC DATE(S); ANDjOR COUNTY WELL ANDJOR SEPTIC PERMIT
FLOOD ZONE AREA DESIGNATION(S) yr[ TAX MAP PARCEL t: ?/I a V,
''
A
FOR THIS PROPERTY: V
TYPE OF CONSTRUCTION:
SINGLE FAMILY
? TOWN HOME
? TWO FAMILY
# of units being
constructed at this
time:
0 RESIDENTIAL (For
Additions, Remodels. Etc.)
PROIECTINFORMATION:
TYPE OF IMPROVEMENT:
X, NEW STRUCTURE
? ROOM ADDITION(S)
O PORCH ADDITION(S)
O DECK ADDITION(S)
? REMODEL
_ Basement Finish only
? ACCESSORY BUILDING
? DETACHED GARAGE
O ATTACHED GARAGE
O DEMOLITION
PLUMBING CONTRACTOR:
Plumber's Indiana State Licens
11,? Uv?vR
Which plumbing codes will be applied to the construction:
International Residential Code w/Indiana Amendments
? Uniform Plumbing Code w/Indiana Amendments
FOUNDATION TYPE: (Chec4,
Gl3r` va
Early Release Manufactured construction area) ,,[?NS'(?
Permit: _Y ?N Trusses: Y ?N O CRAletkslphFx' . Y?
Lot Split: Y ?N Sump Pump: _KY _N
For Single Family and Two Familydwellings, additions, remodels, and/or accessory strb(i
days of the date of issuance of the building permit, and must be completed (Certificates
structure permits are subject to the General Administrative Rules of the State of Indiana
for the new
& tE,AM -PIER
LIE?i?,?\_??N )
ra?ci!'ion commences within 180
; of the issuance date. Class I
time frames for beginning and
1, the undersigned, agree that any construction, reconstruct men[, relocation, or alteraY ! yructuze, or Ry change in the use of land or structures
reouested by this applicationMll comply with, andcvti otm to, all app6ca ws of the State tQ-,a, and [he'Zoaing Ordnance of Carmel Indiana - 1993" (`-
269) and amendments, adopted under a rhor+r? of LC. 36-' et seq, Geaerai Ass ly of the State of Indiana, and all Acts amendatory thereto. I further cemf/ that only
kitchen, bath, and fl ins are ce: et?d to the sanitary sewer. I further mrti that the construction will not be used or occupied until a Certificate of
Occupancyh e ' e b" Wtmentof CommunityServicesC e Tana. 07
.1- Date
OFFICE USE ONLY: *****************
per Footin er Under Slab
Rough In titer Base Final I k/s
fee ewed/Ap ed: 'Dept of Community Services (Date)
S:PemtWl`otms/1 P RESIDENTIAL
Filing Fees: :3 9. 6 0 Base Inspections: # Charged Re-
Reviews
Cert. of Occupancy:
/?•
P.R.I.F.: 61- 0b Additional Fees