HomeMy WebLinkAbout06040074 Application
City of Carmel/Clay Township (jrJ--permit #Dbl)lf-0D7Lf
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER of
RECORD:
t PHONE
~.:tNC 217 SS7 - /bS-~
FAX
31 )-5;((/- 9~3
~el/iew /Jr.
CITY
C&:<-rtl1 el
STATE
IN
ZIP
(oOgs
Ao I ,C~
BEST METHOD OF CONTACT:
317-057- 55
PHONE FAX
%</(-77100 ~03 - SeJO (
PROPERTY
OWNER:
"11;/ aM.
--elf
{J;{-vA
~
~~
ZIP
~ 3.0.
STREET ADDRESS
q999
LOCATION
& PROJECT
INFO:
LOT #
SUBDIVISION NAME
SECTION
ZONING: \
-::,-
SQUARE , -..,L 0
FOOTAGE: " - i:v 19-
Aqqqi:jON>rRU71't-IJ
SEWER UTILITY WATER UTILITY ESTIMATED COST OF CONSTRUCTION:
PROVIDER: {'LA PROVIDER: (EXCLUDING LAND VALUE) :23 s;- =
~~~~~:S~~A~i:)~~~g~~_c~TU~~~(c~~D7~~~~Np~:~r! :~~I~~~~G'CABLE) E It -I-e E IC u~-v d7h
TV; O:I~:~~~?;~~d0'-'~-TY~,1 F~ II PL(f::+G ~JCTO~!kr11 ~
o TOWN ~~ .. " r" llJlJ~ Plumb);r'S Indiana State License #:
o r:~/u: .~~ . r e., ("! 0 (:to(O ~
o MULTH
# of Uni
~ RESIDEN
Additions,
. dO
Whic~umbing codes will be applied to the construction:
l2rInternational Residential Code wjIndiana Amendments
o Uniform Plumbing Code wjIndiana Amendments
(Multi-Family Construction Code)
PROJECT INFORMATION:
Early Release . I :1!\!cl. Manufactured
Permit: _Y ----'L-N Trusses: _Y LN
o CRAWLSPACE
Lot Split: _ Y $-N Sump Pump: _)~3 _N 0 SLAB
Does any part of the property lie within a special Flood designation area: _ Y ~N
FOUNDATION TYPE: (Check all that apply for the new
construction area)
o POST & BEAM
~ BASEMENT
WALKOUT:L--Y_N
For Single ~y-MSi;fillIfiiQiRvijltiilN9fAOO'T~, and/or accessory structures, this permit is valid only if construction commences
. within 18~tfR!tt~e~~ %m\?iit'I~W.w~H and must be completed (Certificate of Occupancy issued) within 18 months of the
Issuance date. ctass I s6r~tln:permits[are su ~>..c~ lp_YM:~~~dministrativc Rules of the State of Indiana (See 675 lAC 12) regarding expiration
~ are ana oca ~es for beginning and completing construction.
I, the unders~~nf'lm~mWcSERVIO~sement, relocation, or alteration of a structure, or any change in the use of land or
structures ~tp;t<t1v:I:~A?ciitt~~w' \y,\'4t-~ii9...C ~o, all applicable laws of the State of Indiana, and the "Zoning Ordinance of Carmel
Indiana - 1993'" (2- 2"B'9) ana arrIe1{~Mt!Ms, a . !mde~N~tj "ltc::. 36~7 et seq, General Assembly of the State of Indiana, and all Acts amendatory
th o. rther certify that only iM , K\.and floor drains are connected to the sanitary sewer. I further certify that the construction will not be
us d r upied until a Certifi e of Occupa. y a been issued by the Department of Community Service~armel, Indiana.
\:) --..I :lA- D .~'-1 ff-D'--r U '1-f'f-l70
Print , Date
OFF CEUSEONLY: ********************************************~*****~******************
Filing Fees: ,~'7, L't2
INSPECITONS REQUIRED' '41' Ch
Base Inspections: 0'-rX ' 00 # arged Re-
Upper Footing L Under Slab S" Reviews
Cert. of Occupancy: ,S'"3 . 50
P.R'~60TAL:,~; ../2 ',17SJ.1;dditionaIFees
~47'fYZ/C-~/
J
Fee Received by:
Site
c.".",,; Q M.~'S.P~ 'I-'Zo.p-f,
Reviewed/ApprLved: Dept. of Community Services (Date)
S:PermitsjForms!ILP RESIDENTIAL