HomeMy WebLinkAbout06050165 Application
City ofCarmel/C/ay Township uM- Permit #D lpo!lD/fol)
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER of
RECORD:
NAME
PHONE
FAX
ShOMonHlnshow
STREET ADDt440 Allison Polnte Blvd.
CITY
STATE
ZIP
BUILi5};oneI~'b2941 Fox 317-842-3389
BEST METHOD OF CONTACT:
PROPERTY
OWNER:
NAME
PHONE
FAX
STREET ADDRESS
CITY
STATE
ZIP
LOCATION
&. PROJECT
INFO:
SECTION
ZONING:
SEWER lJT1LITY
PROVIDER:
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'5 (IF APPLICABLE):
(,D
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT:
~ SINGLE FAMILY ~ NEW STRUCTURE
o Tp'ym HOME 0 ROOM ADDITlON(S)
o ;w>'(fp~L Y
I' it'Uf i,,"o,~ 0 PORCH ADDITION(S)
C H ~nitjT:~:::::;" 0 REMODEL
00/~iThFAl'!tlL-Y,/~ "!7n~
. ,. ~ N 'I Iv ACCESSORY BUILDING
'Jilf f Units: ~'> II .1;;7 ~ DETACHED GARAGE
IDfJjTIAL (For ~ .
W ditiollMbellloc;!els, Etc.) i ATTACHED GARAGE
0: /' " j DEMOUTION
F RMA~6 fb
nufactured FOUNDATION TYPE: (Check all that apply for the new
X construction area)
_Y .: usses: _Y _N 0 CRAWLSPACE 0 POST & BEAM
Lot Split: ump Pump: ~ N 0 SLAB ))'k-BASEMENT y
Does any part of the .'. ~(1)()~lli~b\ ignationarea: _Y --LN WALKOUT:_Y~N
For Single Family a 'S~~~~~d~~fe'bf5e!p,dels. and/or, accessory structures, this permit is valid only if construction commences
within 180 days of te Otw~ riJ-tQlila~g ~~\.l;~t be completed (Certificate of Occupancy issued) within 18 months of the
issuance date. Clas.~'I structure.R~o~~ld ifI~eHl. j \!!srative Rules of the State of Indiana (See 675 lAC 12) regarding expiration
) DEP"T Ul v . tipte'-.v't'N'tsldOW; ,':,' lhd, completing construction.
I. the undersigned, a~Afc@~~l:olfsffuc[ion. enlargement, relocation, or alteration of a structure, or any change in the use of land or
structures requested ~s'.'appucation will~~and conform to, all applicable laws of the State of Indiana, and the "Zoning Ordinance of Carmel
Indiana - 1993" (Z~ 2~9).aDd amendments, adopted under authority of I.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 until a C tificate of Occupa1Jcy has been issued by the Department of Community Services, Carmel, Indiana.
. . L~II/}!J;/OIJ /I!Ju. WfJfA/ ~ {} -()U
Sign ture of w er or uthorized gent Print Date
~ .~.o.
/ 0,. 0,.
ber's Iniliana State License #: "4- @ ~ .0''''
/()~/J{)Oj-'7 ,~.>
Which plumbing codes will be applied to the construction: 1.1)"6'
~ntemational Residential Code w/Indiana Amendments
o Uniform Plumbing Code w/Indiana Amendments
(Multi-Family Construction Code)
OFFICEUSEONLY:************************************************************************
Filing Fees: ~a (20
INSPECTIONS QUIRED: . ~7 --- 0
~ Base Inspections: = _:::>
owe~ Footing nder Slab
r--- ... Cert. of Occupancy: ,\_~ 50
Final -=--~ P.R.I.F.:. /;2 t/ dO Additional Fees
) -:-2.6-0b ~eeRece~ivedt:::<b/V:~ T~~# 02i/ J_ 00
Reviewed/Appro ed: Dept.ofCommunityServices (Date) ~~
S;Permits,lForms/IlP RESIDENTIAL
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