HomeMy WebLinkAbout06060173 Application
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City of Carmel/Clay Township ~ . Permit#: O!aOfoOI'l5
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICA:TION
For Single Family, Multi-Family, & Two Family: New Structures, Additions, Remodels, & Accessory St~uctures
BUILDER of
RECORD:
NAME
D.
PHONE
FAX
l,- Lf34-4
b-Cj.070
I 01. -rt-I ~-r.
cm
Mol.'
STATE
ZIP
4 h d- 80
STREET ADDRESS
PROPERTY NAME PHONE
OWNER:
STREET ADDRESS cm
LOCATION LOT #
& PROJECT 59 ...
INFO: ADDRESS OF CONSTRUCTION
19Cf D...
SEWER UTILITY r:Wc-
PROVIDER: C WD
BEST METHOD OF CONTACT:
'N. '"'oM
FAX
STATE
ZIP
SECTION
6"001
ZONING: p u D
SQUARE 3
FOOTAGE: s: 70
ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE)
foOD 000
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION I BlA I 8PW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE):
BEt --
r'--', r;-.... ,~, r~.;:I
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:
Q(. NEW STRUCTURE
tJ ROOM ADDITION(S)
o PORCH ADDITION(S)
o REMODEL
o ACCESSORY BUILDING Which plumbing codes will e applied to the construction:
o DETACHED GARAGE W International Resid
o ATTACHED GARAGE . . .
o EMOLITION 0 Umform Plumbong Code w/Indlana Amendments
D A~L (Multi-Family Construction Code)
S ~A~
Manufactured IJbjecI t~;ri;;;;:::illtoN TYPE: (Check all that apply for the new
_Y ~N Trusses: y:x..." ofs~4 filOA;s'r-t:>
- ~r ~e~MOF I17V9:J1iQ?f & BEAM
lot Split: _Y -X-N Sump Pump: L'-C%f: Of: ~ oc~i''"'<I/f reg~.'t!N;EMENT
Does any part of the property lie within a special Flood designa -. s. IOn"ALKOUT: Y 1N
e
i
mendmems-'
PROJECT INFORMATION:
Early Release
Permit:
For Single Family and Two Family dwellings, additions, remodels, and/or access~ryI1vt41~lf~': ~ . i ~S-ly if construction commences
within ISO days of the date of issuance of the building permit, and must be completed(Ce1t\Uqate 0 i sued) within 18 months of the
issuance date. Class I structure permits arc subject to the General Administrative Rules of the State of Indiana ~ lAC 12) regarding expiration
time frames for beginning and completing construction.
r, the undersigned, agree chat any construcrion, reconstrucrjon, enlargement, relocation, or alteration of a snuciure, or any change in the use of land or
structures requested by this application will comply with, and conform to, all applicable laws of the State of Indiana, and the "Zoning Ordinance of Carmel
Indiana -199r (Z~ 289) and amendments, adopted under authority of LC. 36~7 et seq, General Assembly o~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 occu a Certificate cay has been issued by the Department of Community Services, Carmel, Indiana.
----fjqY'oN C-. 13>Oe.J'te
Print
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OFFICE USE ONLY: *************************************************,**********************
Filing Fees: Pl'O v (JO
I~PECTIONS RE UIRED: -0
_____ '-- _ _ ab Base Inspections: ;;71. :51
(~~er Fo!!!, wer Footm -<'"'3 ~o
~' Cert. of Occupancy: J . . ..)
Ro gh ~ M.rter~ 'nal P.R.i.F.: (J ~/. 00 Additional Fees
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'"s/ILPRESIDEtmAL F~ ~
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# Charged Re.
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