HomeMy WebLinkAbout06010085-Application
u/fo, I~ J 05
City of Carmel/Clay Township Permit #OltJOIOO(')
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, 8< Two Family: New Structures, Additions, Remodels, 8< Accessory Structures
BUILDER of
RECORD:
NAME
:::r~ f--\ L-o""c; ~
PHONE
"3 \ 7 -51'lS'-'-f 'I L{ 2-
CITY
:r.-. I J'
FAX
317-<t7]-S7,,/O
STREET ADDRESS
"710 .5J~ 'k ~
BUILDER'S EMAIL ADDRESS
STATE
.::rr,
ZIP
4b2iiO
(. .-<.lc..^.\sr..... '-
\"0.
'"
BEST METHOD OF CONTACT:
c~,' ~.........
PROPERTY
OWNER:
NAME
:::f~
PHONE
';317-:)3(1-4<1'-1 z
FAX
'3 \ i-5n:3-S'1'-fO
STREET ADDRESS
S-2.~ ~ Dr
LOCATION
8< PROJECT
INFO:
LOT# ?it
ADDRESS-OF CONSTRUcnON
S-Z, ~vr Or.
SUBDIVISION NAME
CITY STATE
:r:: Lr :::I"
C, /Ie e P la:z:.o-..sECTlON
ZIP
L{ bl,YO
ZONING: R...3
fLv, ~7'P,'-
SQUARE
FOCTAGE:ct 17P"')( 12-00
L
SEWER UTILITY WATER UTILITY
PROVIDER: C'--A-I """M p l.Jp :ROVIDER: "'-""'L \ \
/' -"
NAME OF lITlLITY EXCAVATION CONTRAETOR;'P~ ~~ISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND~~~ W~A~O!~'EPTlC PERMIT #'S (IF APPLICABLE):
/'WNf?~ \\ \
TVP~ OF CON~~V TV MPROVEMENT: PLUMBING CONTRACTOR:
rill SI~6A!!!IV~ 'lS\~'il 0 TRUCTURE ()wney
8 ~O\' \U~ \..~ \ '\ ROO ADD~ON(S) Plumber's Indiana State License #:
- \ -Jr." PO ADD IfS)
# of Ul\iJ;s.; EMODEL ~. ~S~
o MULTI-i'AMn: ACCEIiSO Y Bi:m~<;D ~hich plumbing codes will be applied to the construction:
# of unlt's~ DETA <4lf" C00n ~nt<ltnational Residential Code w/Indiana Amendme
o RESIDEN~(FOr ATTA A i"- ulEit ,v~' '-'U~'
Additions, R mo , Etc.) DEMO o(iJ~ F C () <t"'d ,rm,gii bing Code wI Indiana Amendments
CII Oil1fl_ (tMUl({I'/'~lyl ~ctlon Code) V.
''''''m"",RHAnON~ "~" '. -'"'0 '~ -"0", a ~
'/::'( ~ : (Check all that apply for the ne",! ,/ 11 .
Early Release Manufactured /Iv;-. aj os "",Io.n
Permit: _Y Trusses: 2i;r _N <Jl.1c. ~~ ~
Lot Split: _Y N Sump Pump: .:L.J _N 0 ~LAB ~:s;~ 8 :~~:E~~M /
Does any part of the property lie within a special Flood designation area: _ Y 'J1!...1F. WALKOUT:_ Y LN
ESTIMATED COST OF CONSTRUcnON:
(EXCLUDING LAND VALUE) P
Go. f"'b)(
:z.s oOC
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this permit is valid only if construction commences
within ISO days of the date of issuance of the building permit, and must be completed (Certificate of Occupancy issued) within 18 months of the
issuance date. Class I structure permits are subject to the General Administrative Rules of the State of Indiana (See 675 lAC 12) regarding expiration
time frames for beginning and completing construction.
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 Ordinance of Carmel
Indiana - 1993" (Z~ 289) and amendments, adopted under authority of LC. 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 0 cupied until a enificllte of Occupanc.y has been issued by the Department of Community Services, Carmel, Indiana.
~ 'S-_,." N (,c,,,-,,;:ll\ .3",,- . )1,2u"l,
9 ture of Owner or Authorized Agent Print Date
FICEUSEONLY: *******************************************************~***************
Filing Fees: J). e ' '7.)
INSPECTIONS REQUIRED: " ~
Base Inspections: / h 0- :) 0 # Charged Re-
. ReViews
Cert. of Occupancy: ::;1 -) (J
Upper Footing
Lower Footing
Under Slab
/1i:U-;h'L\ Cleier ~
~\ .
/tldL .
Reviewed/Approved: Dept. of Community Services
S:PermitsjFormsjILP RESIDENTIAL
(Date)
P.R.I.F.: , Additional Fees
~%A~341o 7S'
.. ;2~-Oy
Fee R eive by: