HomeMy WebLinkAbout06020066-Application
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City of Carmel/Clay Township Permit #:0(, 0::2..0061:>
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER of
RECORD:
NAME
PHONE
>r? J"J6-too 2-
(~dJV(le >rATE(;1/'
FAX
"317 "5J /. -toD3
zIP~t:?,.rT
STREET ADDRESS fZ:5lJ
CITY
PROPERTY
OWNER:
BUILDER'S EMAIL ADDRESS
arl_ ,-,c..; ;'{ s,.}. C-".-.
NAME 1_.( , PHONE
f/a- D~,4.- Us1ffAi 7'7 SH o&"tl f
/ ~/"1 A/p.tM/A-t-IC cD:<- ~tfC
BEST METHOD OF CONTACT:
'3'7 P~7 ~?/.,
FAX
J//'-
STREET ADD
TYPE
o
o
o
SING
TOWN
TWOF
# of un
o MULTI-FA
# of Un;
fiS RESIDENT! (For
Additions, R s, Etc.)
PROJECT INFORMATION:
Early Release
Permit:
AD
LOCATION
& PROJECT
INFO:
LOTi
SECTION
"t...-
ZO';l~s
SEWER UTILITY
PROVIDER: IV *
ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE) :2A' 0 cc <>
NAME OF lJT1UTY EXCAVATION CONTRA
NUMBERS; TAC DATE(S); AND/OR
Y v'N
Lot Split: - Y v'N Sump Pump:
Does any part of the property lie ~i!,!i~_~. ~p.t:!=i.al-!:1\'8d,l!~i~...
RUCTURE
OM DDITION(S)
PORCH DDITION(S)
DEL
ACCESSORY BUILDING
DETACHED GARAGE-
ATTACHED GARAGE
o DEMOLITION
I .
:1..7.107 )( ~'
Manufactured
Trusses:
,..ufr
PLUMBING CONTRACTOR:
#' /.-r
Plumber's Indiana State License #:
Which plumbing codes will be applied to the construction:
emational Residential Code w/lndiana Amendments
i rm Plumbing Code w/Indiana Amendments
ul . i1y Construction Code)
(Check all that apply for the new
o CRAWLSPACE
. 0SLAB /.
!grlj'''l~h~Y _N
o POST & BEAM
o BASEMENT
WALKOUT:_Y_N
For Single Family and Two Family dw~Lrm:!t:!l",q~~io~'l~p1~trJ.~,~,~!ln,qt,p.~af.~F~!~rYj~~~~t)l.~, this permit is valid only if construction commences
within 180 days of the date of issuance of the buildiqg.pql"~..N!d m~.~Pt"cQWEteted (Certificate of Occupancy issued) within 18 months of the
issuance date. Class I structure permits are subiectl!b thl?~ne:Ut'Auh;ini~tr~hv~:Rul~lj gf.lhc State of Indiana (See 675 lAC 12) regarding expiration
DER"" ,.'C "'''''clJ'~'' "UjTU C~Jhl\.'M"~'~ .
Im()'JI1t'muun:'uu~In.Rlny 1ntl corup.l(;Jtlno-Q.n~",ructlon.
I, the undersigned, agree that any const~rftliJllS~A~g~tQta'tJ1lf\:vrJfli~!OJf a structure, or any change in the use of land or
structures requcsted by this application \Vin compty\vith, an'd'cqw~ ~ appiica"bkla\vs orthe'State of Indiana, and the ~Zoning Ordinance of Carmd
Indiana - 1993" (Z- 289) and amendments, adopted under authorfd}llffiJP.~ ct seq, Gcneral Asscmbly of the State of Indiana, and all Acts amendatory
thereto. I er 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 occup.'d until a ~ertjficateo[Occupancyhas been issued by the Department of Community. Services, Carmel, Indiana.
(!~ r. M<-//1 ~ '2--I)-O~
Print Date
OFFICEUSEONLY:*********************************************~**************************
Filing Fees: / ~ 5? 171!)
INSPECTIONS REQUIRED: I/Il tJ , ""0
Base Inspections: _'-'_ _ ;:)
ower Footing Under Slab r .e:--- f\
c:::Y Cert. of Occupancy: . -:.> /, 'J ~
Final Sit<;,
P.R.LF.:
# Charged Re-
Reviews
C 102-,-- . Z l -,c'b
ReviewedjAppr ed: Dept. of Community Services (Date)
S:Permlts/Forms!ILP RESIDENTIAL Fee
Additional Fees