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HomeMy WebLinkAbout ApplicationCITY OF CAP ;L / CLAY TOWNSHIP /) RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION \HDIAN/ For New Structures, Additions, Remodels, and Accessory Structures ERMIT # O T Sewer / Water Utility Permit # BUILDER NAME PHONE FAX OF A, 6 +c Jr kwat l - t -WL 317: RECORD STREET ADDRESS Cm STATE ZIP �1G2 E-MAIL ADDRESS BEST METHOD OF �tY�KS 1 r 1/ 1 CONTACT PLUMBING NAME STATE OF INDIANA PLUMBING CODE CONTRACTOR LICENSE NUMBER W iiool5 ElIRC 0 UPC PROPERTY NAME PHONE FAX OWNER pp rr I lid Cc+�u I tDK 317.3 ig. Uf 2 3 STREET ADDRESS ITY STATE ZIP 4qqvt%r 61 Suufc I1 62s'- PROJECT LOT NUMBER SUBDIVISION NAME SECTION LOCATION /6 ' �--� �� T;CrI+LS STREET ADDRESS CITY STATE ZIP ms-w �h�l i L 2 .0- TAX MAP PARCEL NUMBER ZONING FLOOD ZONE/S R-3 LOT SPLIT SEWER UTILITY WATER UTILITY SEWER/WATER ❑ YES ❑ NO C �WKS UTILITIES EXCAVATOR er e TYPE OF TYPE OF CONSTRUCTION MASTER PERMIT FLOORPLAN PERMIT u SINGLE FAMILY 0 TWO FAMILY D TOWNHOME ❑ YES ❑ NO TYPE OF IMPROVEMENT EARLY RELEASE Wf4EW STRUCTURE ❑ REMODEL ❑ ATTACHED GARAGE n ACCESSORY BUILDING ❑ ADDITION - ❑ Room/s ❑ Porch ❑ Deck 0 BASEMENT FINISH ❑ DETACHED GARAGE ❑ DEMOLITION 0 YES ❑ NO PROJECT PLAN COMMISSION / BZA / BPW DOCKET NUMBER/S AND/OR ESTIMATED COST SQUARE FOOTAGE TAC DATE/S OF CONSTRUCTION, /� 13 EXCLUDING LAND 1/ �- PDF PLANS 11P�T�ON �U�RED MANUFA�❑ SUMP PUMP PORCH ❑ CD ❑ EMAIL SLAAB WALK OUT ([/�J}�qjAMr TRUSSES / r ❑ ClAWLSP T &PIER 2 YES 0 NO ❑YES H NO YES ❑ NO STATE OF CDR NUMBER IItEWrt 11 of state and B �trons CONSTRUCTION TYPE OCCUPANCY CLASS INDIANA local DE Codes sco ����jjnvn'�- SER �(` '©► E CDR FOR TOWNHOMES ❑ FDN ❑ PLUM 0 SPKLR R INVIAN ...Willi 1111 Arts u i ma 1111 For Single Family and Two Family Dwellings this permit is valid only if construction com s within 180 days of the da i suance of this permit and must be completed, having the Certificate of Occupancy issued, within 18 months of the f issuance. Class I Structure Pe its are subject to the State of Indiana General Administrative Rules (GAR 675 IAC 12) regarding expiration time fra camp uction. I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alteration of a structure, or any change in the use of land or structures requested by this application will comply with and conform to all applicable laws of the State of Indiana and the "Zoning brdinance of Carmel Indiana - 1993" (Z-289) and amendments, adopted under authority of I.C. 36-7 et seq, General Assembly of the State of Indiana, and all Acts amendatory thereto. I further certify that only kitchen, bath, and floor drains are connected to the sanitary sewer. I further certify that the construction will not be used or occupied�ytrt:illrti sate of Occupancy has been issued by the Department of Community Services, Carmel, Indiana. �L�u6L w5 �'O/ Signature of Own r Autho&ed Agent Printed Name Da REQUIRED BASE INSPECTIONS * Additional inspections may be required. ❑ Lower Footing Rough -In Final Upper Footing Meter Base ❑ Site ❑ Linderslab - 2aii Reviewed / kleased - Department of Community Services Date f................................................................................... .......................................................................................... .. PERMIT FEES Filing / Review t� Re -Review Base Inspections 3 55- 00 Cert. of Occupancy Other P.R.I.F. - 9� d 1 45 TOTAL O F Received - p ment of Cotmrtunity Services Date 1..............................................................................................f S:\Permits\Forms\ApplicationstResidential\ILP Application\2009-08 Last Updated 08/13/2009