HomeMy WebLinkAbout07120081 ApplicationCity of Carmel/Clay Township Permit #:
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
r For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER NAME: PHONE:
317-3tiS-93?9 FAX:
OF I
RECORD: STREET ADDRESS'
12.1109 CITY: STATE'
goo l: rM?? ZEP:
-IV? Y?03
SUELDER'S EMAIL AOGRE55: t??1 (( 1 I
D BEST METHOD OF CONTACT:
rE l E
J b E;/ C?.C7 L • L
PROPERTY NAME:
{ ! l Fr.ONE:
IJ
?+ FAY:
OWNER: c
cT t
p ,.h 3/7-3
STREETADDRESS:
f2 40 S 11
?, ro d; ? cm: /.-.t,rM1 C} ST ATE: ? 1 ZIP:
Z/ d 3?
? N
LOCATION LOTC: t?
J SUBONISION SAME:
( SFCHON:
S 'o ZONING:
l?
& PROJECT , c-r n_
INFO: ADDRESS OF CONSTRUCTION:
IZ> d 3?1T CC-a'!o"a d'
l 4 6 3 2 SQUARE
FOOTAGE:
SEWER UTILIIYr .
PROVIDER: WATER UTILITY
PROVIDER: C/` W C,Nn M.,I ESTIMATED COST OF CONSW
(EXCLUDING LANDVAEJ .rr r, sr,
YiS.S rD#'I_`kYfl TO D
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION I BZA i BPW DOCKET
lI
T'?
r
NUMBERS; TAC DATE(57;AND/OR COUNTY WELL ANDJOR SEPrC PERMIT#S (IFAPPLIrAFLE);
,,
r,,
ROOD 70NE AREA DESIGNATIONS) TAX MAP PARCEL 4: `
FOR THIS PROPERTY: G0 7
TYPE OF IMPROVEMENT:
O SINGLE FAMILY
? TOWN HOME
? TWO FAMILY
# of units being
constructed at this
time:
0 RESIDENTIAL (For
Additions. Remodels. Etc.)
? NEW STRUCTURE
? ROOM ADDITION(S)
? PORCH ADDITION(S)
? DECNADOITION(S)
REMODEL
_Z Basement Finish only
? ACCESSORY BUILDING
? DETACHED GARAGE
? ATTACHEO GARAGE
? DEMOLITION
PROJECT INFORMATION:
Early Release
Permit: _Y/ N?
Lot Split: Y iN
24-7
PLUMBING NT : Y? GCS d
Plumtiels lnd Tana State License #:
Which plumping codes will be applied b
C International Residential Code
I? Uniform Plumbing Code w/Yaj
raa rww uUn i t z mnr>4tt a e new
Manufactured ? mnstrv[tlon are
pG' TiU C
Trusses: _Y L 6"a , 7 gI BEAM PIER
Sump Pump: -Y ? LKOUT: y N J
For Si ogle Funil} and Two Familydwellings,additions, remodels-:m do or tccumoty struccurc513 aPermit 'Fc itctton cummenres within LSO
daps of the date of ieauanre of the building hermit. and must be wmpictnl(Crr4leate of Ctceu ncwfJ{?;a
18t is u(rhe issusnre date Classi
struievur permitsse subject to the Grnzral Administrative Ruicsuf the Starr oI Indiana (See 675JVJ2) uon timeframes far beginning and
cnmpfeting construction. Vv? 1 the undrrsigncd..tt,taI than m can:. '[inn rcumsm.ctian _r ert al CJcn,n[ ItttauonoF?`9( crc, or an hargcC the us'c tf had ur cruceare
r qUe rcJ h,"t I PFlic,li on o alcomply V001, and ,uf,,p n all apph z le l iu_-oF ,hc S[ rcr of lridi ' th anirt;thdunnc,: of C.umcl lnutma ISS3" {,
1n 7) md-.mcvd[n n[6 adt pi:d under authant} ti i t '? e[ ra (. rner:d. _mhfy oCcFt Sc, t -aF €n6m and ill Acts =nc rdat rr} thereto l farther ccTaFy that cMy
kin[-.. butl4,nd? drains in connocad m th m°sa.[iGurhecrru(y[natthrmostruaien uili not he used of occupied until a Ccrnfieate of
ih upanct:hV WLssued by the Depa.tm eat Commumct Services, el, indium.
5,gnatureor Owner or Aulhr vd Agent / it/ttr
OFFICE USE ONLY:
**`****i********'****r
INSPECTIONS REQUIRED: I,
Upper Footing Lower Footing
ough I Meter Base Fini Site
Reviewed/App' ed: Dept. of Commuait`i Services (Date)
Y. Pem'clFm.n9iLP RSFOENTIAL
G
pate
ws*.:r R=*ww**ww*xs*z¦?x**t t :?**x?+•w*w***r-+r*w?w*
Filing Fees:
Base Inspections: > 7d Charged Re-
e ? Reviews'
Cert. of Occupancy: ?S
P.R.I.F.: Additional Fees
I
TOTAL: O?
?? U F
Fee Received Oa