HomeMy WebLinkAbout06050133 Application
BUILDER of NAMES FAX
RECORD: I -z.-zUIo
d: STATE ZIP
t:::: /1'1 (:Jf' S ,0 --1 Iq",~ TN ( ZD3
BEST METHOD OF CQNTACf:
Lu "'"
PROPERTY FAX
OWNER: """ l:>Z
STREET ADDRESS cm STA.TE ZIP
-,<tS- E eur..-te/ IN '/&,D33
LOCATION LOT # SEmON ZONING:
&. PROJECT "-' Car~ Ce...-I-e.
INFO: rd va.rk SQUARE
FOOTAGE:
SEWER UTILITY WATER UTILITY ESTIMATED COST OF CONSTRUCTION:
PROVIDER: PROVIDER: (EXCLUDING LAND VALUE)
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION I BZA / BPW DOCKET
NUMBERS~ TAC DATE(S)~ AND/OR COUNT'! WELL AND/OR SEPTIC PERMIT "S (IF APPLICABLE):
TYPE OF CONSTRUCTION:
o SINGLE FAMILY
o TOWN HOME
o 1WO FAMILY
# of units:
o MULTI-FAMILY
# of Units:
o RESIDENTIAL (For
Additions, Remodels, Etc.)
TYPE OF IMPROVEMENT:
o NEW STRUCTURE
o ROOM ADDITION(S)
o PORCH ADDITION(S)
o REMODEL
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
~ DEMOLITION
PLUMBING CONTRACTOR:
M/.If.,s Indiana State License #:
Which plumbing codes will be applied to the construction:
o International Residential Code wI Indiana Amendments
o Unifonn Plumbing Code w/lndiana Amendments
(Multi-Family Construction Code)
PROJECT INFORMATION:
E I R I ~ M f ct d ~ FOUNDATION TYPE: (Check all that apply for the new
ar y e ease anu a ure .
P't Y T Y N constructIon area)
erm. ~ REtet\ OR C~STRUCilON Vi 0 CRAWLSPACE 0 POST & BEAM
Lot Split: Sul:ljeet"l Plla~t~"''1i'f~gulatiUn'';~N ~ SLAB 0 BASEMENT
Does any part of thectlr61J1!1'tYlliclllidtlliJOll~ial Flood designatio,(area: _ Y WALKOUT:_ Y_N
n wo F !1:Y"i!:v~ ,a dif~.YJ.QQ~. and/or accessory structures, this permit is valid only if construction commences
f FdGAftM.tokq'c{J::~iqr~tPmust be completed (Certificate of Occupancy issued) within 18 months ofthe
Class I struct~[e p91Qe~~tXJject to the General Adminisuative Rules of the State of Indiana (See 675 lAC 12) regarding expiration
'1ime frames for beginning and completing construction.
I"the undersigned, agree that any construction, reconstruction, enlargemem, relocation, or alteration of a structure, or any change in the use of land or
structures requested by this application v..rill comply with, and conform to, aU applicable laws of the State of Indiana, and the "Zoning Ordinance of Carmel
Indiana - 199r (Z~ 289) and amendments, adopted under authority of r.c. 36~7 et seq, General Assembly of the State of Indiana, and all Acts amendatory
thereto. I further certify that only kitchen, bath, and floor drains are connected to the sanitary sewer. I further certify that the construction will not be
used or occupied un .1 a C tiEicate of Occupancy has been issued by the D~partment ~f Fommunlty Services, Carmel, Indiana.
t!11 ck~p I i-feIfHf'$5'I ~/I7J b
Print I Date
OFFICEUSEONLY:************************************************************************
Filing Fees:
Base Inspections:
Cert. of Occupancy:
For Single F
within 180
issuance date.
Signature of Owner or Authorized Agent
INSPECTIONS REQUIRED:
Upper Footing
Under Slab
Lower Footing
Rough In
Final
8
P.R.I.F.:
Meter Base
Additional Fees
~ TOTAL:
d.-ttL'" - L,'- !~~
~~""' v 11;. J (0
~/?{)
Reviewed{Appr ved: Dept. of Community Services
S:Permits/Forms/ILP ESIDENTIAL