HomeMy WebLinkAbout06050151 Application
City of Carmel/Clay Township r)(tpermit #JkOSD/5/
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER of NAME
RECORD:
PHONE
,/t- 276~
FAX
( - 1,..;2- z.
CITY
T.dp//./.
STATE
~.t<
ZIP
(1.2Yu
BUILDER'S EMAIl ADDRESS
/?7 CA /<:<Jt,/
BEST METHOD OF CONTACT:
~ '
-rH?f. . /
PROPERTY
OWNER:
NAME
PHONE
FAX
STREET ADDRESS
CITY
STATE
ZIP
LOCATION
&. PROJECT
INFO:
LOH :2/)
SUBDIVISION NAME
SECTlO~
ZONING: 5-/
SQUARE ( / /
FOOTAGE: r 0 Y <(
ADDRESS OF CONSTRumON
'r JA..!",
C1^-~ WA..
CtA/'f.-.J (
ESTIMATED COST OF CONSTRUCTION:2
(EXCLUDING LAND VALUE) )- CJ'
SEWER UTILITY WATER u:rILITY
PROVIDER: C A E. , ,..., PROVlPEJi.
. '\"vv V /('..-
///~ \\
NAME OF UTILITY EXCAVATION CONTRACTOR;-Pt.ANi..COM 5
NUMBERS; TAC DATE(S); AND/OR cou~ \\yEUl AND/O
/-., \\ ,!/
TY~i;~:70~~~'~'i1Y~ ~P
o TWO FAMILY.~ ~"" 0
# of units: ~ 0
o MULTI-FAMILY
# of Units:
o RESIDENTIAL (Fo
Additions, Remodels
~( 5~ .(1;<7
PLUMBING CONTRACTOR: "'_~~
- r 0,. '? ..0
/-c:;.,../ (J-'~ <? ..L~
Plumber's Indiana State license #: ~4 ~ ~
/ur'i' 0 7' ~~~
Which plumbing codes will be applied to the construction: ~ ~
~emational Residential Code w/Indiana Amendm~
o Uniform Plumbing Code w/Indiana Amendments
(Multi-Family Construction Code)
PROJECT INFORMATION:
Early Release
Permit:
FOUNDATION TYPE: (Check all that apply for the new
construction area)
./ Manufactured ..-/
_ Y "::::'N Trusses: Y N
.......-;; ~ 0 CRAWLSPACE
Lot Split: _Y _N Sump Pump: - Y _N ~B
Does any part of the property I,ie within a special Flood designation area: _ Y <..---If'
':. ...';. ~
For Singlecf,~W ~f\.'i wd' ~11''' ~ ' l1-~~1~1 n. dds, and/or accessory structures, this permit is valid only if construction commences
within 1$d~Y 'Or tRe'tS.rngl'iSsua.~c~ . ~'brnQ~g.~~t. and must be completed (Certificate of Occupancy issued) within 18 months of the
i~uance date. ClasS'V!ri\tatut~~~ ~jie3:.o the General Administrative Rules of the State of Indiana (See 675 lAC 12) regarding expiration
" DEPT.GF COMfVlWNITY ~beginningandcompletingconstruction,
t, the undpr~cJ....AAre,e..tb~Wr'9nsF'}lffiq,ll..,J~q.Q.~t[\1ctlon, eruargemem, relocation, Of alteration of a structure, or any change in the use of land or
structures~c!st~ l;y~fs\ip~HkoIt Wdl-lnmp~~W,rMSf<URrm to, all applicable laws of the State of Indiana, and the "Zoning Ordinance of Carmel
Indiana - 1993" (Z- 289) and amqrN~~pted under authority of J.c. 36-7 et seq, General Assembly of the State of Indiana, and all Acts amendatory
. thereto. I further certify that only kI'td1en, bath, and floor drains are connected to the sanitary sewer. I further certify that the construction will not be
.. used or occu ied until Certificate of Occupancy has been issued by the artment of Community Services, Carmel, Indiana.
, 7.. . L Ct< u L~
o POST & BEAM
G--l!-ASEMENT
WALKOUT:_Y c..--1i
, Sl
Print
'>:-/7' -Q'-6
Dote
OFFICEUSEONLY:*************************************************J'*********************
Filing Fees: ,?5' . ~O
ECTIONS REQUIRED: _
Base Inspections: r-:;J 7 7 <("() # Charged Re-
ReViews
Cert. of Occupancy: .<) 3 .)()
P~~~6d -,--
TOTAL' .P c:/.'15() 7"'0
~ V '
Fee Received by:
5 - '2'7-
Reviewed/Appro Dept. of Community Services (Dale)
S:Pefmits/formS/ILP RESIDENTIAL
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