HomeMy WebLinkAbout06050150 Application
City of Carmel/Clay Township J.~~ permit#~
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER of
RECORD:
NAME
!-(
STREET ADDRESS
51?;;
PHONE ?" crt -2 Cj (."(.. FAX ? 'y6~ Y2ZY
STATE ZIP
;2 L("
BEST METHOD OF CONTACT:
,1
PHONE FAX
BUILDER'S EMAIL ADDRESS
PROPERTY NAME
OWNER:
CITY
STATE
ZIP
LOCATION
&. PROJECT
INFO:
LOT #
70 SUBDIVISION NAME Jf~ h"../
A
SEmON I
ZONING:
LI1
-L
SQUARE J' <-6 3
FOOTAGE: ./
SEWER UTILITY WATER UTILITY ESTIMATED COST OF CONSTRUmONj 0 0
PROVIDER: PROVIDER: U IC- ;., ~ (EXCLUDING LAND VALUE) /' ;; (. d C/O
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION I BZAI BPW DOCKET ."lFObO 50 I 4-'1
NUMBERS; TAC DATE(S); ANDIOR COUNTY WE::.~JJlliOR SEPTIC PERMIT #'S (IF APPLICABLE): 1-( J v, .{' It. (() I<.
TY~CONSTRUCTIONj..-<~ \~ IMPR VEMENT: PLU ONTRACTOR:
-- \\""'1 \7 S
SINGLE F~MI~:r::\\~ \.......Y EW STRUCTURE O~S"\ ~\~ .rr...
o TO,&,N t1qt~K:.'c:-':'?"'-- OM ADDIl.H~C \\'fl ~'!l(s Indi5'a Stat License #:
o TWO.~~MI~Y/ 10C\'O mWoli.\"IOe ~ ~ CO Ct:- ~ .0
#'of u(l!ts: . ~ 'll I,; CO "'"-;'0 \.00'0. 11 \.
o MUL'fI-FA,~ILY \I-~ \ ~o ~~~\.i ~jfql gcodeswillbeappliedtotheconstruction"~ ~
o R:s~d~~~~L (For ~ ~ AC~~ ~~i\.1 ~ternational Residential Code w(Indiana Amendm:~
Additions; R~lnOdels, Et~ 0 ~~lljjiN ~ \~'O\~'tniform Plumbing Code w(Indiana Amendments
\./" '~C\~1f'l (Multi-Family Construction Code)
PROJECT INP9RMAnON:
Early Release v~ .-/ Manufactured FOUNDt\TION TYPE: (Check all that apply for the new
P't Y N T "--<Y N construction area)
erml : russes:
- /' ~ 0 g<AWLSPACE
Lot Split: _Y ~N Sump Pump: _ Y _N ClY'SLAB
Does any part of the property lie within a special Flood designation area: _Y c..--1J
o POST & BEAM
~BASEMENT ~
WALKOUT:_Y_N
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this permit is valid only if construction commences
within 180 days of the date of issuance of the building permit, and must be completed (Certificate of Occupancy issued) within 18 months of the
issuance date. Class I structure permits are subject to the General Administrative Rules of the State of Indiana (See 675 lAC 12) regarding expiration
time frames for beginning and completing construction.
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alteration of a structure, or any change in the use of land at
structures requested by this application will comply with, and conform to, all applicable laws of the State of Indiana, and the "Zoning Ordinance of Carmel
Indiana -1993" (Z~ 289) and amendments, adopted under authoriry of I.c. 36~7 et seq, General Assembly of the State of Indiana, and all Acts amendatory
thereto. 1 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 until a Certificate of Occupancy has been issued by t epartmem of Community Services, Carmel, Indiana.
. i C-fc> CIE.. ')-/y-p&
Date
OFFICEUSEONLY:************************************************************************
Filing Fees: Z~ ~ 3 ()
I~SPECTIONS REQUIRED: .., -7-'7 .//1
r.: =-.::;: ~ ~ Base Inspections: c:>L ~?- S_.lL # Charged Re-
"'"PP'" footing I..!:ower roo~ Under Slab S-" ~O ReViews
Cert. of Occupancy: --,. .
~ '--M~ter Ba~ .~I Sit;) P.R.I.F.: IOJ. &/ 00 Additional Fees
l;JL~ ./,;2357~
Reviewed/Approved: Dept. of Community Services (Date) .- a..s iJ
S:Permits/formS/llP RESIDENTIAL Fee Re ived by:
1.