HomeMy WebLinkAbout06060194 Application
City of Carmel/Clay Township Permit #: O~ 0& t) Li!:t
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, 8< Two Family: New Structures, Additions, Remodels, 8< Accessory Structures
BUILDER of NAME T od d H O.-1/f J (G, 'ZHC.
RECORD:
STREET ADDRESS LJ
r; O. B6X
srt
BUILDER'S EMAIl ADDRESS
_.,jc J) 11.4 J ~
PHONE . FAX:J - S'1f;>
3/'/ jJ(>-S,Jsg J/>-f!if!1 .J'
CITY ' STATE
W~! Tri'F. IJ :t 4/
ZIP
'/60:/
BEST MElliOD OF CONTACT:
~I+,'hc
,; J" !fd./'j /? J, LO
FAX
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT:
o SINGLE FAMILY 0 NEW STRUCTURE
o TOWN HOME" lC-- ROOM ADDITION(S)
o TWO FAMILY 0 PORCH ADDITION(S)
# of units: 0 REMODEL
o MULTI-FAMILY 0 ACCESSORY BUILDING
# of Units:
~RESIDENTIAL (For 0 DETACHED GARAGE
o ATTACHED GARAGE
Additions, Remodels, Etc.) 0 DEMOLITION 0 Uniform Plumbing Code w/lndiana Amendments
~ (Multi-Family Construction Code)
PROJECT IN FORMATIO:/:
E I R I M f ct d FOUNDATION TYPE: (Check all that apply for the new
ar y e ease anu a ure .
P't Y N T' N construction area)
erml : ~ russes: Y _"~
- - - A 0 CRAWLSPACE
Lot Split: _Y Sump Pump: _Y ~N 0 SLAB
Does any part of the property lie within a special Flood designation area: _Y ~
PROPER:rY':,' ,NAME
OWNER: ')vtr. tI ;1'1.1(, ftl/:11 Ell r.~
STREET ADDRESS
If) Lr; .J IJrc ir IF.IV <./" KIf If c.,'1:
LOCATION
8< PROJECT
INFO:
LOT # SUBDIVISION NAME
:)..0 .M/II Q".,./r
ADDRESS OF CONST~N /
O~)3 ~o~~ ~/~~~
SEWER llTILm
PROVIDER:
WATER UTILITY
PROVIDER:
NAME OF llTILm EXCAVATION CONTRACTOR; PLAN COMMISSION! BZA! BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE):
PHONE
J17- !;'/I- ?~{j
'-
cm
CA-rtnr. J
STATE
ZIP
</6 PJG--
-2-.
SECTlON
ZONING:
(!I/'
ESTIMATED COsi-6nONSTRumo~,'---;__,___
(EXCLUDING LANbv":UE!.,; (C' ,;-grr.''(jntJi'::; -~ 1
Ii! II -,,_.. ~"':;~-' ,k_) H'1,1 1,--- r, \ J
I" if'
IL),' I
I < I
I fil!
'"
PLUMBING CON CTO:
l.~ "IA./
A ~A--
Plumber's IndianlLState License #:
Which plumbing codes will be applied to the construction:
o International Residential Code w/lndiana Amendments
o
o
POST & BEAM
BASEMENT ~
WALKOLrr:_ Y-=:::::::N
For Single Family _..:-_. ,; '_ ,? (l . .I!nR, a I'U!" feWBffil~/or accessory structures, this permit is valid only if construction com~ences
within 180 ~ays o6;ili!l~ ~~~~1~!1tH ~€'$11lJ1i Bermlt, and'must be completed (Certificate of Occupancy issued) within 18 months of the
issuance date.- Class I structui.mit~aAd"U~t ~~neral Administrative Rules of the State of Indiana (See 675 lAC 12) regarding expiration
. . nJ: PJ rlF COM M Ul'llt1'l'fn&ff~V<l~ and completing construction.
I, the underSigned'; agrehb.a @'Y const~Hlqn, fefQp-sRl:)Ctfl~~>>l~fprelocation, or alteration of a structure, or any change in the use of land or
structures requeste~-m6sQiiiG.AfniM~bm'p~! adch'o'Mdr'M1:h:all applicable Jaws of the State of Indiana, and the "Zoning Ordinance of Carmel
Indiana - 1993" (Z~289) and amendments, llt4m~A~Ar authority of r.c. 36-7 et seq, General Assembly of the State of Indiana, and all Acts amendatory
thereto. I further certify that only kitchen:t:,;th, and floor drains are connected (0 the sanitary sewer. I further certify that the construction will not be
used or occupied until a Certificate of Occupancy has been issued by the D~p}rtment of Community Services, Carmel, Indiana.
,.. ~...;l ~~ T~dJ WO,,<J~J u, ~KC 6/'2 (10 (
Signature"'~f Owner or Authorized Agent p~r III J J J...I c'.A 14 ,)
OFFICEUSEONLY:**********************************************~************************
Filing Fees: / '/~ ';l...
INSPECTIONS REQUIRED: / J /. J;:;;.. # Charged Re-
Base Inspections: _ b ~ .,jp{!./
pper Footing Lower Footing Under Slab ReViews
,_ / ~ Cert. of Occupancy: '::;-3. c>' tJ
~U9h In, ,./ Meter Base Final Site ")
_ ~ P,R.LF,: Additional Fees
~;w:rAL: J._1E? (;2..
. Jfh ~ ?:>-MJ-Ov
Fee Receive. by: '
c~~
.2V-06
(Date)
j s.e..r-
Reviewed/Ap roved: Dept. of Community Services
S:Permits!formsjllP RESIDENTIAL
Pate