HomeMy WebLinkAbout06050175 Application
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City of Carmel/Clay Township Permit #: vV 0'] [)/,i:)
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For .Single Family, Multi-Family, 8. Two Family: New Structures, Additions, Remodels, 8. Accessory Structures
BUILDER of
RECORD:
NAME
ur1 M.
u '(' ts
PROPERTY
OWNER:
,--,
;:;,a I'te..,
STREET ADDRESS
LOCATION
8. PROJECT
INFO:
LOT -2.-5(."
SEWER UTILITY f) WATER lJTILITY
PROVIDER; L,.: / PROVIDER;
NAME OF LmUTY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE);
TYPE OF CONSTRUCTION:
.ell" SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units:
o MULTI-FAMILY
# of Units:
o RESIDENTIAL (For
Additions, Remodels, Etc.)
PROJECT INFORMATION:
Early Release
Permit: _ Y -.J..N
Lot Split: _Y ~
Does a~y part of the pro e
TYPE OF IMPROVEMENT:
~ NEW STRUCTURE
o ROOM ADDITION(S)
o PORCH ADDITION(S)
o REMODEL
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION
Manufactured
Trusses:
PHONE
-;;
FAX
-8?b-3folE;
PHONE
CITY
C,al-m
.1/Jd.
,
ESTIMATED COST OF CQNSTRUcnON:
(EXCLUDING LAND VALUE) 7 ()C) 0 0 (')
PLUMBING CONTRACTOR:
lU"n~v-- !f R:c.,hf,\./ P{UM6icg
Plumber's Indiana State license #:
PLC- 1i: ID5(,,2. 98
Which plumbing codes will be applied to the construction:
o International Residential Code wI Indiana Amendments
o Uniform Plumbing Code wI Indiana Amendments
(Multi-Family Construction Code)
FOUNDATION TYPE: (Check all that apply for the new
construction area)
Y IN
I - 0 CRAWLSPACE
-'J- Y _N 0 SLAB I
Flood designation area: _Y ~N
Sump Pump:
o
Ja;J
POST & BEAM
BASEMENT
WALKOlIT:LY_N
For Sin'" I ~. &:bw?~i,H~elwrih~iCPd91Jl1.iQfl&lOdCIS' and/or accessory structures, this permit is valid only if construction commences
~"Yi~wit~in ";'.,:. ~ '\iftQ~i:~~ " see:real~~~~lding permit, and m~s~ be c~mplcted (Certificate ofOc~upancy issued) within 18 m?nths o~th~
." t~~a:nc~ da~e., ,clas9,_':~HI~~ _' ermlts 4l..c,s P::~fJ\~~J;leral AdministratIve Rules of the State of Indiana (See 675 lAC 12) regardmg expIratIOn
.....:C. .;" DEP'; ..of,'. CpM UN II Y !ftJ<'fHhf&liJr beginning and complering construction.
I, the !-li1~~.!!g' '. . ." ~ .' roE' ff@WN'Slril!ftlargcmcnt,relocation,oralterationofastructure,orany change in the use of land or
struC[ur~~Jcs~d-b 1" 'p ,dli', . comply \\'ith, and conform to, aU applicable laws of the State of Indiana, and the ~Zoning Ordinance of Carmel
c . Indiana -199r (Z~289) and a ." .'. pted under authority of I.c. 36,7 et seq, General Assembly of the Statc of Indiana, and all Acts amendatory
?~. ';':t~ereto. r further certify that only kitcheii~bath, and floor drains arc connected to the sanitary sewer. I further certify that the construction will not be
."; .: ;..~iised or occupied until a Certificate of Occupancy has been issued by the Department of Community Services, Carmel, Indiana.
< - tt .I;;1.IJt1. f1.Lj);jJj c..Ur -7 M e u rl-S" 5 /7- 411J (0
Signature of Owner or Authk~d Agent Print Date
OFFICE USE ONLY: ******** ******* **** **** ***.~** ********* ***** *?~t * :jf*f********** **********
FIling Fees: { trI-r C9-0
INSPECTIONS REQUIRED: . ( ~ ':;l. 3d 0
Base Inspections: ~ ;.J. # Charged Re-
er Slab .r,1l ReViews
Cert. of Occupancy: "S J - .J v
I d.-6 /. 00
Site
P.R.I.F.:
Additional Fees
l~
Reviewed/Appro d: Dept. of Community Services
S:Permits/FOfms/ILP RESIDErmAL