HomeMy WebLinkAbout06040069 Application
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City of Carmel/Clay Township t)!'V permit#:OltlJt.j.()1)(~
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER of
RECORD:
NAME
; I burY! /3/'0'5 (<:>;151- (6
STREET ADDRESS
[./os- VIS4-", f)~
BUILDER'S EMAIl ADDRESS
PROPERTY NAME
OWNER: ~c=... 00 r z.4/&ki
STREET ADDRESS
57'-7 fYleJo4l1"",.t p4c~
LOCATION LOT # SUBDIVISION NAME
&. PROJECT 30 Z. --Jr/h .4///,'/>/ Gk"
INFO: ADDRESS OF CONSTRumON
57'7 /1?C"A.aW
SEWER UTILITY
PROVIDER: LC. "--"'<0- I
WATER UTILITY
PROVIDER: C '" .-" yo,,,- (
NAME OF LfTlLITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA I 8PW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'5 (IF APPLICABLE);
TYPE OF CONSTRUCTION:
o SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units:
o MULTI-FAMILY
/ of Units:
r:y RESIDENTIAL (For
Additions, Remodels, Etc.)
TYPE OF IMPROVEMENT:
o NEW STRUCTURE
o jlDOM ADDITION(S)
1M"" PORCH ADDITION(S)
o REMODEL
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION
PHONE
L?, I)) '?'II.{-O'l7?>
CITY
~ IJ
Ft-:X
{ 3'/7) 57/-/1'/2.
STATE
-x:;.
ZIP
'Tb ZI? 0
PHONE
BEST METHOD OF CONTACT:
~oo N jL':/1,,,-,,,,, ~ :;; 9 - 202 D
Ft-:X
CITY
L+rp,~.J
STATE
:::z;.,
ZIP
SECTION
/0
ZONING:
~-3
\
i4
SQUARE
FOOTAGE: S l. 4'
ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE) d 12.. 000. 000
I r(i.:~'T~~r---~-"-'-'-'- ...
, ; i I !' 1..1 ~ i ' [
PLUMBING CON:r~ctOR:2CC6 , !::
i i I-'! I ' ' "I 'I i I
". ,II \ i I i ll:~3 I 006 ';
Plumberis Indiana Sta~':JL~i!nse #:' I ! i '.:,
L..-----.......-I'- ..Lc:::.==c.::J.-.----uJ ,.--
Which plumbing codes will b~,app1ied.to.the,cDnstrUction:_"__.
o International Residential Code wI Indiana Amendments
o
Uniform Plumbing Code w/Indiana Amendments
(Multi-Family Construction Code)
PROJECT INFORMATION:
/' ......--FOUNDATION TYPE:
Early Release ~/ Manufactured ~ t ct' )
Permit: Y N Trusses: y ==' cons ru Ion area
. - - - 0 C LSPACE
Lot Split: _Y _N Sump Pump: _Y' ~
Does any part of the property lie within a special Flood designation area: -Y..JN
(Check all that apply for the new
o POST & BEAM
o BASEMENT
WALKOUT:_Y_N
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this permit is valid only if construction commences
within 180 ~)E! Pfe1x=8~f~F-tt9CJl.J~~~J4il\iHllPin~.i.'.. flnd must be completed (Certificate of Occupancy issued) within 18 months of the
issuance date. '"&~T~crute pMtffi:sWs~t!~~ GtY!~1 Administrative Rules of the State of Indiana (See 675 lAC 12) regarding expiration
SubJeet toeomplionee witililllt fll@ltlalifllilltinning.ndcompletingconstruction.
I, the undersigned, agre~~.ste~~d~c;;~lr~00O"SIf:tion, enlargement, rclo~ation, or alteration of a s~ruc ur or_in the ~se of land or
structute>tequ_tlrif;dJ~~~~t!!mto.allapp~~ . ' gOrdm.nceole.rme!
Indiana -1993" ~ 9 a'rr'd'am'tn"d'rHe; ,t'eduhHi!t9u~l! i ~ l.c. 36-7 et s.V .- " ,Acts amendatory
thereto. I furtJiJ. c r IthGbmijMab,j1:G lTcGwa.! I:fihnccted to die sanitary sewer. furdier ccrti y that the construction will not be
used or occupied until a Certificaf 'P!cyhas been issued by the Departmcnt of Community Services, Carmel, Indiana.
~. . ~. i. ,q ,.c;1'''.-''~ S'r S;c 'I~J~'
Signature of OWner or Authorized Agent Print Date
OFFICE USE ONLY: *********
Upper Footing
Final
P.R.LF.:
C~;~I~ ,- Q-V-06
Reviewed/Appr ed: Dept of COmmunity Services (Date)
S:Pefmits/Forms/ILP RESIDENTIAL
Fee Received by:
****************************************
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/ Ite; S-IJ
I 53- So
# Charged Re.
Reviews
Additional Fees
3?