HomeMy WebLinkAbout06030055 Application
. City of Carmel/Clay Township \p'~ . \~~ permit#:O<eD3(JVSS
RESIDENTIAL IMPROVEMENT'i~~ATlON PERMIT APPLICATION
For Single Family, Multi-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
N \ Vlv\~~'~ \~\;)~ Lt(
STREET ADDRESS
LPlPtDlc l;-.iS"U> ":"::>i. *'-/00
PHONE
'1St{
FAX
BUILDER of
RECORD:
-\ <6'1 $
em
$v-- IS.
Sf ATE
::t:.IV '
ZIP
1.{&f)75b
STREET ADDRESS
C9lJ>lD~ t. 7~ S\. "'Hlee:.
BEST METHOD OF CONTACT:
"
e""",,-,l
PHONE '2N~-I~'7S- FAX
em STATE ZIP
:l:~ IS -X,J , -/(,,";))0
PROPERTY
OWNER:
BUILDEB,'S EMAIL ADDRESS
\'Y\{\l<;SC'~"'" ~",~\'b.~\"'''~ \\C-. c.",,,,,,
NAME;,
CS,\vui\..-cv""-L \-\ov.....L':. Lt. ~
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA I BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WEll AND/OR SEPTIC PERMIT #'5 (IF APPLICABLE):
SUBDIVISION NAME
SEmON
ZONINGS
LOCATION
& PROJECT
INFO:
V\.~ S~\xll v ISl ~
SEWER UTILITY
PROVIDER:
ADDRESS OF CONSTRUCT.!ON
\ ,..v"," ";\
WATER UTILITY
PROVIDER:
SQUARE I "1\":l..
FOOTAGE: U \ ,->
ESTIMATED coST OF CONSTRUCTION;, 0 '::t ~
(EXCLUDING LAND VALUE) ot 0 J'2>\...J-.I
Ii
....r t- $-e <.0"-r
l0~ \"::>~~,! w
(j L'..J,-'O
F N TR
SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units:
MULTI-FAMILY
# of Units:
RESIDENTIAL (For
Additions, Remodels, Etc.)
TYPE OF IMPROVEMENT:
~ NEW STRUCTURE
o ROOM ADDITION(S)
o PORCH ADDITION(S)
o REMODEL
o ACCESSORY 'i1Jll-.D_1NG Which plumbing codes will be applied to the construction:
o DETACHED ~ASED~ternational Residential Code wI Indiana Amendments
25 A~~~O~ijt to cohQ~i~l!lTl!i"a.Q!.de w/Indiana Amendments
D M 0 of State -/~OOm-fi11ll'1la"M~(J[)NJe)
PROJECT INFORMATION: EPT OF ~~~'-BiWiml';fJW~tio
Early Release / Manufactured CRY OF C~: ['l1\eck all that apply for the new
Permit: _ Y ~ Trusses: V -..; _rFARMr!!i'~ @ftAVICE~
Lot Split: _Y LN Sump Pump: --;:Zy _N IN~~ I{s~WtJIS~~~~E~~M
Does any part of the property lie within a special Flood designation area: _ Y LN WALKOUT:_ Y -/ N
N:
I!' i II
PLUMBING CONTRACTOR:
,\-n3 t"",4';::-"..-:<.-'kov3-
Plumber's Indiana.Sti!!~Jjcense #:
<:J \ DIo Lj S- 4 0 -.-.-------------
o
o
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this permit is valid only if construction commences
within 180 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 \\'lth, 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. 1 further certify that only kitchen, bath, and floor drains are connected to the sanitary sewer. I further certify that the construction will not be
d or QCe led un a Cat' 'te of Occupancy has been lssued by the Department of CommunIty ServICes, Carmel, Indiana
. '2,Od-'r; 2t.\~5 .f-~ oa?' - SS '0(.,
...h
"'.
~,
Fi al
Site
P.R.I.F.:
Additional Fees
Ned: Dept. of Community Services (Date)
.1' RESIDENTIAL