HomeMy WebLinkAbout06040151 Application
City of Carmel/Clay Township ~permit #:(/lp04.0/S'/
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER of NAME
RECORD:
4
/"'Ie.,
STATE
LJ
BEST METHOD OF CO'i.~ I .522..4
FAX
PROPERTY
OWNER:
NAME
PHONE
STREET ADDRESS
em
STATE
ZIP
. e at Oee.;- Clf\'" SECTION
(Y)I L n:> '2)ireet
SEWER lJTILITYCI 10 /' WATER lJT1LITY J
PROVIDER: AY n fbidJllJ\i;:~ PROVIDER: ~ 6
~. /' \"., " \\.
NAME OF UTILITY EXCAVATION CONTRACfOR; PlAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR'COUNiYwaL A/'iP/OR SEPTIC PERMIT #'S (IF APPUCABLE):
/" "'-......1/'. \\\ \\
RucfuClN:/ \ ,\ \~,
SINGtE,FAMILY i)l<:0'<:>
o l~N:~OME 'I.. '<:> 0 ROOM ADDmON(S)
o ~~'~~~ILY ~~ 0/ PORCH ADDmON(S)
#\~(un~~: ~ /b REMODEL
o MUl'~;fA~~LY // 0 ACCESSORY BUILDING
# of \J~, 3'\ 0 DETACHED GARAGE
o RESID or /. 0 ATIACHED GARAGE
Additions, e~lS, Etc,) 0 DEMOLmON
PROJECT INFORMATION:
Early Release / Manufactured /"
Permit: Y LN Trusses: _Y -ILN
---z L 0 CRAWLSPACE
Lot Split: Y 4-N Sump Pump: Y _N 0 SLAB
Does any part of the property lie within a special Flood designation area: _Y ~N
LOCATION
&. PROJECT
INFO:
LDH 2.J.tD
ZONINGp
SQUARE Q:::r:,3
FOOTAGE: 10 0
ESTIMATED COST OF CONSTRUCTION:
(EXClUDING LAND VALUE)
85 000
f/firoL.1>S E'''CAvMIDN
PLUMBING CONTRACTOR:] (
Ens. A(Y)t:nc(VJ 'low/tJ f5
Plumber's Indiana State Li1;nse #:
e, C I CUAlJOOc-,
Wh~ plumbing codes will be applied to the construction:
~ International Residential Code wI Indiana Amendments
o Unifonn Plumbing Code w/Indiana Amendments
(Multi-Family Construction COde)
FOUNDATION TYPE: (Check all that apply for the new
construction area)
o fiST & BEAM
~ BASEMENT
WALKOLrr:_Y_N
For Single Family and T~q.Jjapli.Jy.d}ll.:elJ.llJ.g~~ditions, remodels, andJ(lr accessory structures, this permit is valid only if construction commences
within 180 days of the EIl~r..,~bttihiHt~!t9@ifij.@~ completed (Certificate of Occupancy issued) within 18 months of the
issuance date. Class I stdldtbijepttioi~~u;bjec:~l!Q..y~e,~~~~~~~9"ative Rules of the State of Indiana (See 675 lAC 12) regarding expiration
of State a.WPtg~ft!Br:;J~~ginnmg ana completing construction.
I, the undersigned, agre~~.le;~QP~tru. I ~tion. ~~ement. rqocation, or alteration of a structure, or any change in the use of land or
structures requested by , atkln will 'eOiitplyl""lJI,Ianil' c&fufiilJ~licable laws of the State of Indiana. and the "Zoning Ordinance of Carmel
Indiana -1993" (Z-289) G e@Iii uE. '~~"'~Ufsq, General Assembly of the State of Indiana, and all Acts amendatory
thereto. I further c that only kitchen, t ains :rr'e'c~~~8e'dYo[he sanitary sewer. I funher certify that the construction will not be
used or occupied a Cerr J fa c n issue~;e~ o~ M~;t~rvices, Carmel, Indiana, '3 17/010
Slgnatu Print " Date
Site
5'0
, :S' 50
/7vu I, 00
J:~L' 1,;,\\"::11,1.3 G
Fee Re by: tA \ 1.~ \t>I.t
OFFICE USE ONLY: ***********************~*******************
~ Filing Fees:
INSPECTIONS RE UIRED: . ~\\1'b
Base Inspections:
U ab
. Cert of Occupancy:
# Charged Re-
Reviews
P,R,LF,:
Additional Fees
tL,l I~ 4.
Reviewed/ Approv : Dept of Community Services
S:Permits/FormS/ILP RESIDENTIAL
.06
(Date)
.-