HomeMy WebLinkAbout06050044 Application
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CityofCarme//Clay Townshipj;r ~0605oo'l5 permit#fYotJ5004t
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
NAME r,' I J PHONE
L u sf-owt "Vof:!Ct4J()(/ ~S ~ . f?(p 7 -2 If 2
STREET ADDRESS . 1'/) f ,/7 CfT'! , , I STATE ZIP
e-,-O uJ~r;f./!.Jv H!rv 'C V,. (/./cr;.f-{...'It:/ tV C-(fR07
, BEST METHOD OF CONTACT:
ue;f/{"C.O~ ff/lC+ '?-Lf7 ~ 372;)
FAX
'Yb?-21 0
BUILDER of
RECORD:
BUILDER'S EMAIL ADDRESS
WOtUK.CuJ
NAME OF UTlUTY EXCAVATION CONTRACT ; PLAN COMMISSION / BZA I BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNlY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE):
NAME
~ /'o~
PHONE
FN<
~;;>tf3C)
PROPERTY
OWNER:
!- . L()
CITY STATE
C;
4JJ.~
Ck'V<<-l/~ l(ggo
7~372
LOCATION
& PROJECT
INFO:
SEWER lITIL"l" ; /' /
PROVIDER: L~ L- /,
ESTIMATED COST OF CONSTRUCl}931:
(EXCLUDING LAND VALUE) -PI.::::.
TYPE OF IMPROVEMENT:
o NEW STRUCTURE
o ROOM ADDITION(S)
o PORCH ADDITION(S)
'g) REMODEL
o ACCESSORY BUILDING Which plumbing codes will be applied to the construction:
~ "0 DETACHED GARAGE ~ International Residential Code w/Indiana Amendments
ATTACHED GARAGE 0 r-- ----.----.-.
o DEMOLITION Uniform Plumbing Cod,W/~ndi~,n~'Am~~c~"1~~ts/ . '. ,;~' I
(Multi-Family constructlOj fP9~)f~ -; _.~::::.-- :=- ::,._:~ -- \!....._'- :':11; \ 1 !
PROJECT INFORMATION: . ,,) II I' \,
E I R I I Manufactured FOUNDATION TYPE: fF~~f~ all that apply for the new II \11
.AI.~P~~~it~ease _Y..L...p Trusses: _Y 'XN construction area) :;1 II! MAY - 4 2006 II ,I,
'~ V N 0 CRAWLSPACE :lplll~OST & BEAM '[01
Lot Split: _Y _N Sump Pump: lY _N 0 SLAB !Jif BASEMENT---~..-___J I
Does any part of the property lie within a special Flood designation area: - Y -X:N I WALKOUT:---=-:~N,. J
TYPE OF CONSTRUCTION:
'1s6 SINGLE FAMILY
6 TOWN HOME
o TWO FAMILY
# of units:
o MULTI-FAMILY
# of Units:
o RESIDENTIAL (For
Additions, Remodels, Etc.)
$'50000 ~~rk>>e-
PLUMBING CONTRACTOR: L.. f~ T / J
I _ I -5 ~~t' f:;-LS E'1<;;.5c'1..)
Plumber's Indiana State license #: I
<:;;-10(:) 'i?/ok
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this permit is valid only if construction commences
within 180 d~~btA~etY~ e6",~g~fl!d must be completed (Certificate of Occupancy issued) within 18 months of the
issuance date. ~~uMure per~vts ~e ~u~.k~t '~O tnel;le~ril}enera1 Administrative Rules of the State of Indiana (See 675 lAC 12) regarding expiration
U ject to COmpl.an,.e Ntj'rhEl~ith\W er~ilming and completing construction.
I, the undersigned, agree tlG't ~~8ri~tipytdl&{;~c(;ds~ion, enlargement, relocation, or alteration of a structure, or any change in the use of land or
structures requ_s ~i flPR1fJA Gm-~m. to, all applicable laws of the State of Indiana, and the "Zoning Ordinance of Carmel
Indiana -1993~ , ) a~1P e v, ~2ic>pt ei~l i' Qf.I,~ 36~7 et seq, General Assembly of the State of Indiana, and all Acts amendatory
thereto. I furtl1 r If at~. . , Had..: o~r..eT :tctMilected to the sanitary sewer. I further certify that the construction will not be
used or occupied until a Certificate rotP/M'JI'iYhas been issued by the Department of Community Services, Carmel, Indiana. .j ,/_
---J;;- u' /0 ti<'1 !-h4vVI j, 5' Ltf f) 0
Signature of Owner or Authorized Agent Print"-... Date
OFFICE USE ONLY: *************** **~* ***** ********************************************
5: a Fili 9 Fees: ,/ 3 ~ ~ 0 ,
INSPECTIONS REQUIRED: / J
Jf' se Inspections: & C. ~J # Charged Re'
Upper Footing Lower Footing SI~ ' 8 (; /' ReViews
_ Cert.ofOccupancy: .s" 'Z, ..,-()
Site
eter Base
Final
P.R.I.F.:
Additional Fees
v
TOTAL: P .3.:5
,-Yu<1f a 7Lbd~r
Fee Received
3.S[}
19 16~
I
. C~'i5.0
Reviewed/Appro d: ept. of Community Services (Date)
S:PefmltsjFormsjILP RESIDENTIAL