HomeMy WebLinkAbout06040123 Application
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City of Carmel/Clay Township Permit #:~3
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER of
RECORD:
NAME PHONE
c.\FZCI..E- C;1::Ty CON11ZAeroe.-::',lIvc:... -;>11 7/07927
FAX 02.20
?17 B23-~
STREET ADDRESS
p.O. ~ :2lP3\t.-\
cm
i N.bPLS
STATE
iN
ZIP
4'-'22
BUILDER'S EMAIL ADDRESS
C.\lZC....e..a:: W\A'CL(2 ~6c..
BEST MnHOD OF CONTACT:
,-C)f3Ae..,t-J~r "317 7/D7,f'z
PROPERTY
OWNER:
NAME
f:vv tzA-t0
LOCATION
&. PROJECT
INF05q~~
SEWER UTILITY /_
PROVIDER: 0().rrneJ
De..
PHONE
587 - 0 U
cm
C4Y2-~
FAX
STREET ADDRESS
, 5z~ 67 TJl.tJA-iVtl
STATE
IJ
ZIP
'14-033
ZONINS/ LOvl
~gg~~~E: , '30 g-
e~~K:.
SECTION
ADDRESS OF CONSTRUCTION
- T1\1-J~t..J(>.. P\2.
I
ESllMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE)
58, ()VV
NAME OF umLI1Y EXCAVATION CONTRACTOR; PLA
NUMBERS; TAC DATE(S); ANDfOR COUN
o
PLUMBING CONTRACTOR: ;;
- Ht..-71r7tJ/;- /f'z.v rt:J1l/A.-G-
ADDITION(S) Plumber's Indi a State license #:
ADDITION(S) ~.-;)."." '" Q b. . .
REMO EL B5mf. \~ u: iM (X) ",0, 'PT ~
DRY BUILDING Which plumbing codes will be applied to the construction:
DETACHED GARAGE o-1nternational Residential Code wI Indiana Amendments
ATTACHED GARAGE . . .
DEMOUTION 0 UnIform Plumbing Code wI IndIana Amendments
(Multi-Family Construction Code)
PROVEMENT:
o
PROJECT INFORMATION:
Early Release / Manufactured FOUNDATION TYPE: (Check all that apply for the new
Permit: y ~~ Trusses: ~ _N construction area)
VIIl 0 CRAWLSPACE 0 POST & BEAM
Lot Split: _Y _N Sump Pump: Vy _N 0 SLAB ~ASEMENT
Does any part of the property lie within a special Flood designation area: _ Y ~ WALKOUT:_ Y ~
For Single FamiijilaIiAa;figi.lfG.Ql~NSdiaUGId(9.Nand/or accessory structures, this permit is valid only if construction commences
within 180 da)8ubjOC41:ttJ: Q&M~h!Ae~lmhvib#~g,~m~.Hhjt~ must be completed (Certificate of Occupancy issued) within 18 months orthe
issuance date. Class I stru&r-lffiB'ffirwFfJII:d~~f~,t,<(jf.ht General.Ad.ministrative Ru~es of the Stat~ of Indiana (See 675 lAC 12) regarding expiration
? ~ time 'frames for~~mmng and completmg constructlon.
I. the undersigne!i?ijPeltjQliin~Qtl4ll<'\kI~1dh~@'Vlo...JmSment. relocation, or alteration of a s cc . e.o a .~-..
structutesrequ@tTh(])iFa~~m. ~yi9'~~N'SJl11IlI>allapPliCable]aWsoftheState " i' III .. ...
Indiana -1993" (Z-289) and am~ndm t t under ~thority or t.~. 36~7 et seq, General Assembly 0.. .. ijJl,;:'
thereto. I further certify that only kit , , floor drains are connected to the sanitary sewer. I furt er certify that the construction will not be
used or ied until a Ce~tifa;e of Occupancy has been is artment of Community Services. Carmel, Indiana.
F/L- t-t /ZDfr;&
Owner or Authorized Agent Date
INSPECTIONS REQUIR
Upper Footing Lower Footing
QOii9h 0 Meter Base ~ Site
. of Occupancy:
OFFICE USE ONLY: ************
-2
ReviewedjAppr ved: Dept. of Community Services (Date)
S:PefmitsjForms,lILP RESIDENTIAL
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P.R.I.F.: Additional Fees
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