HomeMy WebLinkAbout06060022 Application
~
06 0 t, 00 .:t-;1..
City of Carmel/Clay Township (/~permit #: ~Q f:1 O)~
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER of
RECORD:
NAME . PHONE .,. ol FAX
\-\0l"\'l.1. 'c~ \n(. Lo.u~\.\~ I ":toe... ,,111 - ql2S~- '1t'h;z.. . W'l- ~IS"-Ia 15
STREET ADDRESS
1"I(f~. '('('.ou..)'oro.! ":k ru.,k-
CITY
~o.t \"'\t. \
STATE
.IN
ZIP
'ifo0'3~
BUILDER'S EMAll ADDRESS
c..\ \'t.Q.1\ ~ Y\o l"l4S
L' . BEST METHOD OF CONTAcr: n I...o^"
(W'\~\Q.Ll.!!ln\'N ,(.Q<<\ r., . '--
PROPERTY
OWNER:
NAME
,.
\.
STREET ADDRESS
\1\
, .
LOCATION
&. PROJECT
INFO:
LOT #
'd.\o
SUBDIVISION NAME
\J\\\Q t...Cl~ \..lQ.~* tolo..
PHONE
FAX
I'
I'
"
\.
CITY
STATE \ I \I
ZIP n "
"
"
9S~~N3 ZONING: ~\JO
Ll SQUARE. .
., ~ i(J ~ _FOOTAGE;Jo~(l3
~~.r;;=nnf7r:==.---.. !
~~~~6~~l1tfr,r~~~~)SJiut~1 \V,I ~~f\I\1
I r\ I III 1'1
I1111 JUN - 2 2006 ill J/i
PLUMBIN:iNT €-TOR, ,- J u. i /
. '/ ~f2f-r-a/!J1l;(f_~
Plumber's Iridiana State License #:
ADDRESS OF CONSTRUcrrON
I ~ ~ ~ \.0 \'l\t.("CcU st., t....f ,..a. \ I 'tW
SEWER umlITY l.'~~ 'O"""'1>h; p WATER UTIlITY :I.ncl.. CU\...~\. ~
PROVIDER: ~,,,,,,,.;t. \;:l'lST... PROVIDER: ..,... \<.(' ~... 9""
Manufactured FOUNDATION TYPE: (Check all that apply for the new
X v construction area)
_Y _N Trusses: _Y ~N
X 0 CRAWLSPACE
Lot Split: _Y -X-N. ._SumpPump: _Y _N 0 SLAB
Does any part of the property lie within a special Flood designation area: _Y ~N
NAME OF umlITY EXCAVATION CONTRAcrOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (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.)
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
PROJECT INFORMATION:
Early Release
Permit:
Which plumbing codes will be applied to the construction:
~ International Residential Code wI Indiana Amendments
o Uniform Plumbing Code wI Indiana Amendments
(Multi-Family Construction Code)
o
~
POST & BEAM
BASEMENT
WALKOUT:_yLN
For Single Family ancR&b.~df~ 4GN&TditbJ:QtlQNr accessory structures, this permit is valid only if construction commences
within 180 days oft~tJ.ef ~~rf'lt'f\~C'tf.iWttm8itre9"ataUoM be completed (Certificate of Occupancy issued) within 18 months of the
issuance date. Class I strudure 81r~a~erafflf~Eij,.tBlt~. al.Ad.ministrative Ru~es of the Stat~ of Indiana (See 675 lAC 12) regarding expiration
time 1r~fs qI. /~nd completmg constructlon.
I, the undersigned, agreEiEP<iliyGEsGQMMU~drbCli ',Ii ~&l.~eloca(ion, or alteration of a structure, or any change in the use of land ~r
structures requested ~~e~.:Ri.4FJlPl~'~~SH~licaPle laws of the State of Indiana, and the "Zoning Ordinance of Carmel
Indiana. -1993" (Z'28511~ddla~'tddments, a'd~jj(ea auth~ritY at I.e. 36-7 ct.seq, 'Gencral Assembly of the State of Indiana, and all Acts amendatory
thereto. I furthcr certify that only kitchen, bIN,QI rains are conncctcd to the sanitary sewer. I further certify that the construction will not be
use occupied until a Certificate of Occupancy has b e artment of Community Services, Carmel, Indiana.
Print
~
Date
Signature of Owner or Authorized Agent
OFFICE USE ONLY: ********** *******fi******'~***** ***********'**2* ****~******************
( FUlng Fe : / a ~cz., .0 6
INSPECTION QUIRED: . b /' ~V I """'-,7
C-:_. ~ , Base spections: ,;2 7 '7. .,) 1/ # Charged Re-
~er FO~ L er Footing Under Slab /'-3 .~() ReViews
rt, of Occupancy: .;::> ,:,) I
Q.OU9hI"~ P,RJ.F.: ;2. Additional Fees
c.v-1I'-~~ f1/~ <;'-6 ~c;{,
Reviewed/Approv : Dept. of Community Services (Date)
S:Pf!rmitsjFOfmsjILP RESIDENTIAL
~