HomeMy WebLinkAbout06030136 Application
CityofCarmellClay Township ~ l. ).)f Permit #OHJ go 13~
RESIDENTIAL IMPROVEMENT L~~ATION PERMIT APPLICATION
For Single Family, Multi-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER of
RECORD:
f l0"-E R-
PHONE
3 \ I ..,:, 3- --,
OTY
2 '-~ L..::l.s.vl~L-L~
STATE
..-L}.J
ZIP
L--\loOt
BEST METHOD OF CONTACT:
0*,
PROPERTY
OWNER:
PHONE
FAX
L
CITY
STATE
ZIP
LOCATION
& PROJECT
INFO:
LOT #
F- LUf $I C
SECTION
i.OC)\ L
ZONING:
'\(>"S\.l'-u.r-t 1ft:
SQUARE
FOOTAGE:
SEWER UTILITY
PROVIDER: C, '? W.I:::.
. WATER UTILITY
'.<~i'OVIDER: X W c:..
E MATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE) ~ :=,S-O . DO
" "',,-
NAME OF UTILITY EXCAVATION CONTRACTOR;'PLAN,plMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNWWE[l'AND/OR SEPTIC PERMIT #'S (IF APPLICABLE):
--.'/ \,\ \
PLUMBING CONTRACTOR:
~\2..\c:.5- SM. rn-!-
Plumber's Indiana State License #:
?c.. \ 0\ DO,). \ )(
..,/'
F CONST U N:/ ROVEMENT:
SINGLE'FAMILY. NEW RUcrURE
TQ\o/~.t19~E' M ADDmON(S)
o "TWO. FAMILY
# ofuhits:\ ORCH ADDmON(S)
o Mum:FAMILY., REMODEL
# of Unifs\ \\\ ACCESSORY BUILDING
o RESIDENTIAl? (For DETACHED GARAGE
\ ATTACHED GARAGE
Additions, Rem~~ tc.) DEMOUTION
PROJECT INFORMATION: h ~
/ 1'11=1 I::A~ FOUNDATION TYPE:
Early.Release 'i .. M~ii!jrCWil!IED Fno construction area)
PermIt: _Y -2..)1 Triimwlimto eo~:-Y> STRU
,f " n~ nee Wit'" Cn~LSPACE
Lot Split: _Y _N ~(!)F' ,rat tuca'l~ all regwatiaJ.{ilj /
Does any part of the property IQ . ~r~I' ~ area: _Y ~N
Which plumbing codes will be applied to the construction:
o International Residential Code w/lndiana Amendments
~unifonn Plumbing Code w/lndiana Amendments
(Multi-Family Construction Code)
(Check all that apply for the new
o .,..I"OST & BEAM
G2( BASEMENT /
WALKOUT:_Y~N
For Single Family and Two Family dwellings, ad'ditions, r ds~v so QSsur~. this pennit is valid only if construction commences
within 180 days of the date of issuance of the building P~/~an.d/rnusi b ~~tificate of Occupancy issued) within 18 months of the
issuance date. Class I structure permits are subject to the GenerafAltr4unistrative Rui'eS'd'/tlie 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 amend ts a te uthority of l.c. 36~7 et seq, General Assembly of the State of Indiana, and all Acts amendatory
thereto. Hu er. that 0 ch ,and floor ains are connected to the sanitary sewer. I further certify that the construction will not be
used il Cert.' te rpancy has n issued by the Department of Community Services, Carmel, Indiana.
\<'A\-)~Il-LL- S. S.\.\-A-\=:-H1L. t'R?5
Print I
3 [ :2.D~
Date
**********************************************~********************
Filing Fees: /(6) 10
INSPECTIONS RE. QUIRED: ( -) /'. . .., .-/} # Char ed Re-
~ ..~~ Base Inspections: " /' G9 & ) [/ 9
~per F~ __ n _. . __ mIg Under Slab '" ~/ ) Reviews
. Cert. of Occupancy: ) I ') (
J r). {/
,
Rou
r Ba
P,R.I.F,:
~
Reviewei:l/Approved: Dept. of Community Servl es
S:Permtts/Fonns/ILP RESIDENTIAl
(Date)
Ii 0 Additional Fees
Jj G n:: /()
~.