HomeMy WebLinkAbout06040030 Application
City of Carmell Clay Township Permit #:O~()Y ~ 0 30
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER of
RECORD:
NAME
Cs,nsrl2..5t:.-T";.-J Sir<l /~ AfS't>c-.
STREET ADDRESS
/GvG.- Cr.~S'(
BUILDER'S EMAIL ADDRESS
C-A"S"/6K./Y>ANl'leJhc. {.."bill.~f
NAME
4A,u;- C!.Julckr5
PROPERTY
OWNER:
LOCATION
&. PROJECT
INFO:
STREET ADDRESS
3D? Co{..J,.... ...;"'"
LOT # SUBDIVISION NAME
42- E~'4Te::S
ADDRESS OF CONSTRUCTION
12/7(, /bft.. L-v.
PHONE
.3'/7- </o7-01Z 7
FAX
3i7-S7:> -~5'OS'
CITY
STATE
,../
ZIP
~&. Z4>~
(i,S
BEST METHOD OF CONTACf:
PHONE
a75'-S~oo
CITY
e.;++ldcJ
FAX
STATE
J..J
ZIP
SECTION
ZONING:
.rz..
SQUARE //,5;'
FOOTAGE: . .. [ ". .F
WATER UTILITY
PROVIDER: .7/JdI.;PJ
ISSION I BZA I BPW DOCKET
PTIC PERMIT #'5 (IF APPLICABLE):
ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE) I;;: ooeo . """
o
J
~
PROJECT INFORMATION: ~
/'
Early Release I Manufactured ./
Permit: _ Y -"'--iN Trusses: Y N
v' / 0 CRAWLSPACE 0 POST & BEAM
Lot Split: _Y _N Sump Pump: Y ~N 0 SLAB .a BASEMENT
Does any part of the property lie within a special FI"-?d....'l-I\~ig ;,..~JC:\ql).- N WALKOUT: Y XN
For Single Family and Two Family dwellings, a4ditl~#eh\S~1s...<\n~qr.@:ceSsbtrf~ir9,c1we~, this permit is valid only if construction commences
within 180 days of the date of issuance of the It*lB1eg.:-petfuit~~lrl~~~~*,jQl-G9rp;p'ieGal.(e~.hip,~ Occupancy issued) within 18 months of the
issuance date. Class I structure permits are subj~h to the G9~enu:Aani~!st:r<l~~!\lleEHE~f iana (See 675 lAC 12) regarding expiration
I, the undersigned, agree ~hat any c~nstru:tion, r~~~:~~Y&:=:~~':~~~~~l~ as. ' UnJ~1 ~l~.n- All:.'
structures requested by thIS applIcatIOn Wlll compl)".~a~lt~:lli(i;tRn1'm~n' ~<tt~aws of the State 0 a, n~~:;'i~~~D:/b~~~
Indiana - 1993" (Z~ 289) and amendments, adopted 'tm\:ih'auth~rity of r.c. 3~ E4~~eral Assembly of the State of Indiana, and all Acts amendatory
thereto. I further certify that only kitchen, bath, and floor drains are connected to the sanitary sewer. I further certify that the construction will not be
used or occupied until a Certincate of Occupancy has been issued by the Department of Community Services, Carmel, Indiana,
&......::L...- ~ - Lk:.& S;€'~A.J.,J
OFFICEUSEONLY:******************************************************~****************
Filing Fees: / '3 '3 J 0
INSPECTIONS REQUIRED: . / / / (JO
Base Inspections: <-,+
Upper Footing Lower Footing Under Slab I ''''-0
Cert. of Occupancy: :> 3 J'
SEWER lJTILITY
PROVIDER: ~
NAME OF LfTlUTY EXCAVATION CONTRACTOR'
NUMBERS; TAC DATE(S); ANDIOR COU
TYPE
o
o
o
STRUCTURE
ADDITION(S)
PORC ADDITION(S)
REM EL
CESSORY BUILDING
DETACHED GARAGE
ATTACHED GARAGE
DEMOLITION
F
SIN
TOW
TWO
# of
MULTI-
# of Un
RESIDEN
Additions,
PROVEMENT:
1 'l.\)~~8
t1'\\ .. .t
~
, tc.)
o
o
Signature of OWner or Authorized Agent
Print
CROU9~'
~~
P.R.I.F.:
Meter Base
C'n1":.;;); HI<,pr/ L/"'1/~O-b
ReviewedjAppr ved: Dept. of Commumty Services (Date)
S:PermitsfForms/ILP RESIDENTIAL
Fee Received by
z.
PLUMBING CONTRACTOR:
Pa...s.1 E.. S........#-
Plumber's Indiana State License #:
c,PB/o 17771
Which plumbing codes will be applied to the construction:
M" International Residential Code wI Indiana Amendments
o Unifonn Plumbing Code w/lndiana Amendments
(Multi-Family Construction Code)
FOUNDATION TYPE: (Check all that apply for the new
construction area)
<lILlI <0"
Date
# Charged Re-
ReViews
Additional Fees
-~o~o~