HomeMy WebLinkAbout06060115 Application
\
,
City of Carmel/Clay Township (}t- Permit #:O~oro 0 lIS-
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
Manufactured FOUNDATION TYPE: (Check all that apply for the new
\../ \~ construction area)
_Y -<2-N Trusses: _Y ~N
,/ ~CRAWLSPACE
Lot Split: _Y ~N Sump Pump: ~ Y _N 0 SLAB
Does any part of the property lie within a special Flood designation area: _Y_N
For Single Family and TwO..fiW~~4..~r'f'I;~iGo.w-al, 0 acc"ssory structures, this permit is valid only if construction commences
within 180 days of the da~~!iJt~e~~Jie.Jt~. i\4t'nt1tJhfQQM\iJ.~'1"mpleted (Certificate of Occupancy issued) within 18 months of the
issuance date. Class I struct&\it'PlDiikAPa~*Hf~c Jp t Ibm' &iJl1inistrativc Rules of the State of Indiana (See 675 lAC 12) regarding expiration
of Stat~ill.\l\h 1'~ II" ~pleting construction,
, It the undersigned, agree that ~~t~@M.M\Jll~J~, e' .epf~ ~i\~j1, or alteration of a structure, or any change in the use of land or
\structures requested by this aptrfibboh c 'h'/~C ~r a~~Ii~!p,le laws of the State of Indiana, and the "Zoning Ordinance of Carmel
~ndiana -1993" (Z-289) and @t~GE: ~u "ry of LC. 36~7 et seq, General Assembly of the State of Indiana, and all Acrs amendatory
\ereto. I further certify that only kitchen, bath, an4KGt re connected to the sanitary sewer. I further certify that the construction will not be
,
.t;up,ed untd a Certificate of Occupancy has been ISsued by tbe Depactment of CommunIty ServICes. Cacme!. Ind,ana
~L<..rv'vv\.t r ('./ eo.. nJ (J&, /S, 00
e of Prmt / Date
EONLY:*********************************************~!************************
Filing Fees: L 7 ~./ 0
\ INSPECTIONS REQUIRED: ., ,--' ') 00 # Charged Re-
~ Base Inspections: ~.zo<.
\o~ Lower Footing und,er s~ab ~) . "-0 Reviews
- Cert. of Occupancy: '-' J '
~ Site I' C/ (JO
P,R.I.F.: r/ .
C~-/~OTAL:/74, # ~ ?> 0'1 c. 0
~~.
NAME 'I)
-r~L~CDOJr
/-(OM:CS
BUILDER of
RECORD:
STREET ADDRESS
s.fS s C '7(; 7H STR
PROPERTY
OWNER:
NAME
SA.ME A <; ~'Bov'E"
STREET ADDRESS
LOCATION
&. PROJECT
INFO:
SUBDIVISION NAME
t\<;\-I. u Ii 1'l\'\<-\~
l'Sa EPIS;ON \tJ1\j
WATER UTILITY 0 ip 0 (Q 0 I \":s
PROVIDER: 0A ~ M tL
LOT #
2:
ADDRESS OF CONSTRUcnON
SEWER UTILITY
PROVIDER: CLA Y TWIV S P
NAME OF UTIUTY 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:
@: SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units:
o MULTI-FAMILY
# of Units:
o RESIDENTIAL (For
Additions, Remodels, Etc,)
TYPE OF IMPROVEMENT:
2;( 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:
~
I
i J < ,....,r (0 ~I q ~6.{.,
'pt. of Community Services (Date)
."I1AL
Fee Received by:
FAX ,
3/1. S101o. /33
ZIP
4&:'2<1-D
PHONE
CITY
ESTIMATED COST OF CONSTRUcnON:
(EXCLUDING LAND VALUE) 1J;?,S lo
HELL Y
PLUMBING CONTRACTOR:
5AUL ~ SMITH
Plumber's Indiana State License #:
lit I
f/O
Which plumbing codes will be applied to the construction:
l8rintemational Residential Code wI Indiana Amendments
o Unifonn Plumbing Code w/Indiana Amendments
(Multi-Family, Construction Code)
o POST & BEAM
o BASEMENT
WALKOUT:_Y ~N
Additi9nal Fees