HomeMy WebLinkAbout06030023 Application
CityofCarmel/C/ay Township ~.(g,. J....JJ.:k Permit#: (!)(gD "3eb23
RESIDENTIAL IMPROVEMENT LOCAf;ON PERMIT APPLICATION
For Single Family, Multi-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER of
RECORD:
NAME
H
PHONE
't6--2'16l....
FAX
';;y.{- (/22.. r
PROPERTY
OWNER:
/Cd
ZIP
NAME
PHONE
STREET ADDRESS
CITY
STATE
ZIP
LOCATION
& PROJECT
INFO:
LOT# 2/2-
SUBDIVISION NAME
C((.lrI/A"-#/c
SECTION
'?
./
ZONING: 5 /
SQUARE
FOOTAGE:
YtJ3
ADDRESS OF CONSTRUCTION /} 'i 7 3
SEWER UTIUTY
PROVIDER:
Cr It?;)>
WATER UTIUTY
PROVIDER:
/C{/
G,/<./'1~
fr[
kJ,,-
it
ESTIMATED CO OF CONSTRUCTION:
(EXCLUDING LAND VALUE) 2. n d If r:f,
!.L.
NAME OF UTIUTY 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:
O/"SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units:
o MULTI-FAMILY
# of Units:
o RESIDENTIAL (For
Additions, Remodels, Etc.)
-("A/..:.-(.
TYPE OF IMPROVEMENT: PLUMBING CONTRACTOR:
I9-"'NEW STRUCruRE ~ --- ( rr-r~
o ROOM ADDmON(S) Plu,,{be~ Indiana State'l.icense #:
o PORCH ADDmON(S) /01'7 tf .,
o REMODEL '
o Rtfa.~SORY BUILDING Which plumbing codes will be applied to the construction:
~u~_~IlA,G,E C1'fntemational Residential Code w/Indiana Amendments
o DEM~8'NIP~~E CON~Wt.o..rm Plumbing Code w/Indiana Amendments
UE:PT ..........;:,,(0 ',r Ice lVith all'-:~~ Construction COde)
PROJECT INFORMATION: C OF Co ' Ie LOCal C regu/atiQl:m.
Early Release M tT;yc;tQ!ecCA MIvtUN'-"".1::NDAn"NTYPE: (Check all that apply for the new
_Y <./CN anu a "P/:ul121' I r O1IsI!rud;ion area)
Permit: Trusses: -F!::.Llj1 Ay ...~l;
C/;:; ~l '-Ii II PACE
Lot Split: _ Y _N Sump Pump: "':::ylJ \I\~ tp
Does any part of the property lie within a special Flood designation area: _ Y ~
C
A
0,. A.~
-t~.. ~" "~A
~~"1I
~1' :>
".>6'
o POST & BEAM
B--tiASEMENT
WALKOUT:_Y '-4'i
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this pennitl~~alid;!!J2lYJt.~p~tru<ni~l~o~ii~es .
within 180 days of the date of issuance of the building permit, and must be completed (Cenificate of OCCURanc~. i~~~t~~18;m~~9fl" t', \';
issuance date. Class I structure permits are subject to the General Administrative Rules of the State ofIndi~ (~ l67:'HA012)"tegarrung exp' . on :, \.
time frames for beginning and completing construction. \ \ \) \ \J \
I, the undersigned. agree that any construction, reconstruction, enlargement, relocation, or alteration of a structur~1 char-~l W the l.l..if O(~ or It))
structures requested by this application will comply with, and conform to, all applicable laws of the State of Indian, k e"~ c:rrcliRantt!b'tt~cll
Indiana -1993" (Z-289) and amendments, adopted under authOrity of I.e. 36~7 et seq, General Assembly of the Stat . I lana, and all Acts amendatory \
thereto. I further certify that only kitchen, bath, and floor drains are connected to the sanitary sewer. I further cere t t the con<:f"....,"tieft-wifrrror e
used or occupied until a ~icJlte of Occupancy has been issued by the Depanment of Community Services, annerIndiana.
'-# 7 ~-v<- rj?, C C--,e () t.C- j .-] - ri
Signature of Owner or Authorized Agent Print f Date
OFFICE USE ONLY: ******** **** ** * ****** *****,******** *** *** * * ** *1'.************* *** ******* ***
FIling Fees: 2t~3, 30
'INSPECTIONS REQUIRED: _ J / 7. .::0 # Charged Re-
o Base Inspections: <:7 0 , -'
~er Footi"g> Under Slab ,-/, ~O Reviews
Cert. of Occupancy: J _ ~
~ Si - P.R.I.F.: I,) (,! 00
~ JOT.rA,y:;f vl f;z 3, 3 0
~Ln )(::a~ 3-9-0("
Fee Rived by:
Additional Fees
(Date)