HomeMy WebLinkAbout06050176 Application
City of Carmel/Clay Township ~ermit #(JdJ5oI '71.0
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER of
RECORD:
PROPERTY
OWNER:
LOCATION
&. PROJECT
INFO:
J / '-T' PHONE
/"70 111 e S <h'JC, 5"(17-7'
cm
a,.-,.,.~ ::t:A/
BEST METHOD <]H:O'ITi'CT:
@~/Ctlh1 C~/I; 5'"C/7-70/0
~E
s 90-0/'1 2Lj.
;J/iC-Ce C%.I~''1t2 ~ /t:IA"7iV
, ~cnON
e ~./' tt/cs-/ Cia 'FF. {!OO
J2tJ tfl c/
NAME ---r: L
..J tt.-Go t:l
STREET A[~ESS
p. O. I3tJ
BUILDER'SplfIL :ODRESS /
!:5ndl1 L
NAME 1--
f'..ard
STREET ADDRESS
/ :s-&
LOT #
87
853
~4>6
g;;',.--d
f?a.-?J
SUBDIVISION NAME
7h~ f//II~
ADDREjS OF CONSTRUcn)W- . I.
/q~o f-,'"chle>'
SEWER UTlUTY
PROVIDER: C'T ;!? tV P
g0~ 3'38(;
STATE . ZIP
6tJB2
F~
I
WATER UTILm --r j .
PROVIDER: ~,;1~
ESTIMATED COST CONSTRUCTJ>lIl.i.-:7 /-tf,'O -1
(EXCLUDING LAND VALUE) :u ' I tJ 7
I r-~ _ ~, I
'/ ii' .., I
1/ nh...~.. .7 17 IAI In r: i
if f jllL.L \ I ," ~-, .- <C'... - ..-1. . '. I ',;
PLUS2MBI/1NG C!.ONT~:~ ,~j::5.j': [~::;' f! \7~~;::::,'~
/> U -1"'" i , , .rvmlJll1"-", .1-":
c-. ~., ,," I . . '-',: I ::
Plumber's Indiana S!:lite'License #: Ii i j',
f}C8ItJS-Q5!?',5AY 24 2DD6 Ii! Ii;
f - '-'I ii; I/J
Which plumbing codes will/be apptied.to.the.Q!nstruction: ,f! ~Ji l
----.- J '--' I
~'International Reside.~~i_~I_~~de wI Indiana Am-.;;;aments !
o Uniform Plumbing Code w/lndi;''iJAiiieifdments-__..J
(Multi-Family Construction Code)
NAME OF UTlUTY EXCAVATION CONTRACTOR; PLAN COMMISSION I BZA I BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'5 (IF APPLICABLE):
TYPE OF CONSTRUCTION:
,
~ 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:
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 FOUNDATION TYPE: (Check aU that apply for the new
V 'V' construction area)
_Y ~N Trusses: _Y ~N
V 0 CRAWLSPACE
Lot Split: _Y -,6-N Sump Pump: ~Y _N 0 SLAB
Does any part of the property lie within a special Flood designation area: _Y
ex POST & BEAM
9U BASEMENT
WALKOUT:_ Y
N
N
For Single Fam~miij~EbCghUilau,C.tlQlN, and/or accessory structures, this permit is valid only if construction commences
within 180 da$t..di)dle~~Watl'Otf Wftht-ttUJi""",tatiOmtl must be completed (Certificate of Occupancy issued) within 18 months of the
~.E issuance date" q~ss I stI1Gf-18',~'!1~~at~~. General Administrative Rules of the State of Indiana (See 675 lAC 12) regarding expiration
. . ;. ( , , ~-k~ {r~ning and completing construction.
I, the undersignJ!~I tQfaiJ.9~~~ ~~c~n~, ~ment, relocation, or alteration of a structure, or any change in the use of land or
s~ructures reqtE34~y(f).f; <6ARMet.UYc@WAVirow~P, all applicable laws of the State of Indiana, and the "Zoning Ordinance of Carmel
t _ Iiidiana - 1993~ (Z~ 289) and amendmfJl1f~~tflfl- under authority of I.C. 36~7 et seg, General Assembly of the State of Indiana, and all Acts amendatory
" thereto. I further certify that only kit~h~~h~trtd floor drains ire connected to the sanitary sewer. I further certify that the construction will not be
:~. iI. Certifi: UpanCYh?~ bYg~::m~~;~;tY7":~t;e1;;::.s )" /~'7 M6
Signature Print / / Date'.
OFFICE USE ONLY: **************************.~******************lA**~*M*****************
FIling Fees: I~ OL Lf)
INSPECTIONS REQUIRED: . "7/71. /(j # Charged Re'
Base Inspections: ~ I' ~ :::L
pper Footing Under Slab ,C""'. /' A ReViews
Cert. of Occupancy: J .J lY
P.R.I.F.: /2 (, I. (JO
4:.~OT;t~,JL~~~(
~OU9h 1~
.
Final
Site
0.,.....;
Reviewed/Ap oved: Dept. of Community Services
S:Permits/Forms/llP RESIDENTIAL
(Date)
Additional Fees