HomeMy WebLinkAbout06020106-Application
City of Carmel/Clay Township 'J.lv/ ~ . permit#DbO.1DJOb
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER of
RECORD:
NAME
/
STREET ADDRESS Q A.'? /l
I C/Z),I/" f'T. 'v...".. '1 'c/
BUILDER'S EMAIL ADDRESS AJ / /
/J7 c;, (.....,/ "~/",,-/I ,
PROPERTY
OWNER:
NAME
STREET ADDRESS
LOCATION
& PROJECT
INFO:
LOH 2 I
SUBDMSJON NAME
SEWER UTIlITY ~
PROVIDER: '- ( ;( w .,:)
WATER UTIlITY C
PROVIDER: ~ ,. ,.." -< I
PHONE
FAX
i-21/<-
CITY
t-/f//J//1:
STATE
ZIP
( 6.2- 'to
c""-
BEST METHOD OF CONTAcr:
;::. /?'". '
PHONE
FAX
cm
STATE
ZIP
SECTION.
ZONING: 5/
We;,
SQUARE L ,
FOOTAGE: ,F/1....
ESTIMATED COST OF CONSTRUCTION:
(EXClUDING LAND VALUE) "/ '1 J JcJJ, ~
NAME OF UTIlITY EXCAVATION CONTRACTOR; PLAN,COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL 'AN9!OR SEPTIC PERMIT #'S (IF APPUCABLE):
.-.\\ \"
~- ,.,~., II 1'\
TY~ CO~STRUCTI,~N:,_.>/ '-TYPE OF IMPROVEMENT:
~It!G~E. €A~ILY .: -- ~ \,:~'EW STRUCTURE
o TOWN\I;IOME ?, 1'00D '[s;;l~ I\OOM ADDmON(S)
o TWO F~t;1ILY ~'?> 1- " PGRCH ADDmON(S)
# pf, unit?: ~ 0 REMODEL
o MUl1f.F~~ILY ~--ACCESSORY BUILDING
# of \)nits: 0 DETACHED GARAGE
o RESIDENTIAL (For 0 ATTACHED GARAGE
AdditionC,~models, Etc.) 0 DEMOLmON
PROJECT INFORMATION:
FOUNDATION TYPE: (Check all that apply for the new
Early Release / Manufactured /
.......-- - ~ - construction area)
Permit: _Y -=--,N Trusses: f:/fE,L~ _N ~WLSPACE 0 POST & BEAM
Lot Split: _Y.....---N Sumppumellb' ecnN B'SLAB ~ Q--BASEMENT
Does any part of the property lie within a specr:H Y N WALKOUT: Y----N
For Single Family and Two Family dwellings, ,']e ~iaQi~~~s ~' ,~,~=~t is valid only if construction commences
within 180 days of the date of issuance of the n ,~.u,si'!SkO!J;lI?l~ . . .~~!.1f.'1VOccupancy issued) within 18 months of the
issuance date. Class I structure pennits are subject to t~. ~'d;Miiiiitr:M:W~~~ e Indiana (See 675 lAC 12) regarding expiration
time frames for ~ ~-c~hlP*'&5hstruction.
t, the undersigned, agree that any construction, reconstruction, enlarg; t, r~nt-_~.~ ljiA, structure, or any change in the use of land or
structures requested by this application will comply with, and conform to, " . DI~ ~M} ]~~of Indiana, and the "Zoning Ordinance of Cannel
Indiana -1993" (Z-289) and amendments, adopted under authority of I.c. 36-7 et s ,General Ks~~iN.he 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 t&i:her cenify that the construction will not be
used or occupied until a ~7te of Occupancy has been issued by the Depanment ~unity Services, Carmel, Indiana.
f';;Z' ;: ~~ ~-r:~ - IP t. C,.e()C.r;;. 2-L l-d6
Signature of OWner or Authorized Agent Print Date
OFFICE USE ONLY: ** ********* **** ****** * ***** *************** ** ******** ********** **********
, Filing Fees: fj~t ~O
INSPECTIONS REQUIRED:,/- /)
/:: - /' ~ ~.--- :."\ Base Inspections' 0< (,; 7. .5> ~ # Charged Re-
C Upper Foot' ~wer FooE!Jg Under Slab . ,/ t1 Reviews
, Cert. of Occupancy: 5 I.:>
(Ro'~~. Mete~ ~I ~ / ;Z 6! /)0
~\\ .1 ~ \) ~ ~ P.R.I.F.: -
\Ii~ ~ // ,/-j/()0.drJ I
\J\j L . ~ I o~
,
~( J tA -<" ::'otoO:? 0 10 S-
PLUMBING CONTRACTOR: C
&.. I (/-.n' 'f.:. ~"'// III
Plumber's Indiana State ~Icense #: 0,. A.:. ~
/0)' 7d <{ 't~";8~<t~
Whi~h plumbing codes will be applied to the construction: 'O6:~l,.
CtlQ International Residential Code w/Indiana Amendments -'01:
o Unifonn PlumbIng Code w/Indiana Amendments ~
(Multi-Family Construction Code)
Additional Fees
Reviewed/Approved: Dept. of Community Services
S:PermIts/Forms/ILP RESIDENTIAl
(Date)