HomeMy WebLinkAbout06020073 Application
~':ty ofCarmellClay Township (/f/tpermit #:(N O~ 0013
....:.SIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
,"or Single Family, Multi-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
TYPE OF IMPROVEMENT:
~ NEW STRUCTURE
o ROOM ADDmON(S)
o PORCH ADDmON(S)
o REMODEL
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLmON
PROJECT INFORMATION: ------ 0
Early Release '
Permit: _Y -XN Trusses: ~,
V ~ CRAW
Lot Split: _Y -A-N Sump Pump: ,N -, ~ SLAB
Does any part Ofth~"pr~~,:~;!!!!;Yo(it!li_l\a-Spec~iiFi~d'J.~.!1~~tion area: _Y XN
. .. _ '. ,~-...li~'p{"'A 1."lltl 0.:1 ......~';J_.._-
For Single Family and::rw<?:Fainily dwellirigs~ a.dd~ti~E-,~"rem~4~ls. and/or accessory structures, this permit is v~d only if construction commences
within 180 days of the date of ~uaiiceohhebtilding Pe\fui~:AA~1 ~~lb8.completed (Certificate of Occupancy issued) within 18 months of the
issuance date. Class I s~~c:ure.peql!!t~~...~P)$~lW'~etal.1Ulniillistii~e Rules of the State of Indiana (See 675 lAC 12) regarding expiration
L t: j-" I ~..:... t-tiptel~1U1l~ryr ~..:ftJ9Q.!P.dl~ompleting construction. _ .,.~" ~ .~ " .
I, the undersigned, agr5\t\ii( an~f(1I11SttMtlg.~ reeonstm~on, enlaigement, relocation, or alteratioX:':~~.ftffi5rw~t~y ~p~ge ~ tlj~_ us~ 'of land or
s~ctures req~ested by this application will col*M\yj4~ftbV~.d c~nform to, all applicable laws of the StfJt\WiI~~ ~_~!~5l_~oxiWg 9n1lnal1Se of Carmel
Indiana - 1993 (Z- 289) and amendments, adopted under authonty of LC 36-7 et seq, General Assembl\i 0~l'lslQ:<'6F1nHiiilil an1tan Acts amendatory
thereto. I further certify that only kitchen, bath, and floor drains are connected to the sanitary sewer. I funher certify that the construction will not be
used or cupied un a CertiB' te of Occupancy has been issued by the Depanment of Community Services, Cannel. Indiana.
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Print I
ONLY:***********************************************~~*****!****************
Filing Fees: '7--3 f, () ()
INSPECTIONS REQUIRED: '/ _ J'-
~- Base Inspections: " 6 7~ tJ # Charged Re-
(!fpper Footin~wer Footini) Under Slab e ..r /(J ReViews
Cert. of Occupancy: c::L I ' )
~inal S~ P.RJ.F,: I'd.. 'I- 00
<--?~MfIg.~~~L:J //;' &/_ ~/:[ 6 0
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JER of
_':ORD:
NAME
\ill
SI-
BUILDER'S EMAIL ADDRESS
PROPERTY
OWNER:
(don
STREET ADDRESS
2, -'5 G kbe.. SI-
LOCATION
& PROJECT
INFO:
LOT #
SUBDMSION NAME
of ne.
.-\- re.e..+
IP
SEWER UTIlITY
PROVIDER: CT
NAME OF UTIlITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPUCABLE):
TYPE OF CONSTRUCTION:
~ SINGLE FAMILY
o TOWN HOME
o 1WO FAMILY
# of units:
o MULTI-FAMILY
# of Units:
o RESIDENTIAL (For
Additions, Remodels, Etc.)
11
, - 9 ''2 - '2-- Dh
Reviewed/App ved: Dept of Community Services (Date)
S:Permits/Forms/ILP RESIDENTIAL
Fee ReceIved by:
PHONE
~7 - 582-0'100
FAX
3n-5B2-CAo
01Y
Ca.. n\E:-\
STATE
I
ZIP
Lj.("()32.
BEST MErnOD OF CONTACT: \
.Co,'Y'\ e 1'1,0..\
PHONE FAX
~\, -5&2-oQCO 3lf -56:L-
o
CITY
Co..( ."r\e...
STATE
~
ZIP
t-~ 032-
SECTION
2.
ZONING:
-~.-_.---~---
--SQUARE--: ," ..:, 1
r~cX?TAGE:;C;:Ht:;' ) 0
, -.1 l,.__~. ~ l.D
\r~\ ft~~{ (c)~; !
,.' 1_ .____._._
ESTIMATED CQ?fjQ~ CONSTRUcnON~
(EXa.UDlNG LAND,VALUE) 'I'
\1. '\ I
\\J ~.\
'l'lli
I I ''I
I j. ll~c.o
! , ~
'Iii li\
IlL)}
lL.J I
PLUMBING CONTRACTOR:
L D Me(LlO.\I i (~(\t--.. - ---.-.
Plumber's Indiana State License #:
lCO i(ol" 3
Which plumbing codes will be applied to the construction:
);g(Intemational Residential Code w/Indiana Amendments
o Unifonn Plumbing Code w/Indiana Amendments
(Multi-Family Construction Code)
(Check all that apply for the new
POST & BEAM
BASEM ENT
WALKOIlT:_Y~N
~. IS'Olo
\2 13 Or)
Oate
Additional Fees