HomeMy WebLinkAbout06070010 Application
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\ City of Carmel/Clay Township Permit #: ()GO( 00 10
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
STATE
:{Zi
BUILDER of
RECORD:
NAME
/P J J PHONE
2Ji. L-<!>/'IS/t"V<<-T,'OrJ If'<-. J I
,S'M . </"~r
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BEST METHOD OF CONTACT:
.s: t!). -If!.2?-
PROPERTY
OWNER:
BUILDER'S EMAIL ADDRESS
e - i/l t! . t:c
NAME
~4 VU<1.nl\'4"-1\.~
PHONE FAX
STREET ADDRESS
C8L' ()S
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STATE
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LOCATION
&. PROJECT
INFO:
LOT #
SUBDIVISION NAME
6' ~ t-<:...+.e
SECTION
11-
TYPE OJ. CONSTRUCTION:
~SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units:
o MULTI-FAMILY
# of Units:
o RESIDENTIAL (For
Additions, Remod
ESTIMATED COST OF CONSTRUCTION:~ / -.
(EXCLUDING LAND VALUE) 'f'(J}CJ tJ<:JO
Irr rc: (0 fi=" D~;7 'c' r;-::\!
'n IS~?!.S l \'ll~~ lr\;l
I ~______ I, "I
TYPE OF IMPROVEMENT: PLUMBING CON ! I i J')I
o NEW STRUCTURE Co J 'I
o ROOM ADDITlON(S) Plumber's Indianaf ' License #: I ~
o PORCH ADDITION(S) 'XLl. f c \ <::;G
lB"'REMODEL &"r.+~~/.c -J -I
o ACCESSORY BUILDING Which plumbing codes ill-l>e-applied~c>___ion.----J
o DETACHED GARAGE 0 International Residential Code w/Indiana Amendments
(0 ~~i ~~~ ~:-~Y~~~i;'\L' 0 ~~~~~_~~:~~:~;~u~~:ne c~~:~diana Amendments
/" Manufactured" .... .\..-"" ~~~t~u~~o'?~~;rvPE: (Check all that apply for the new
Y v N Trusses: Y N
- - A,- -
Lot Split: _ y...-r; Sump pu,f.;':iJ< ~ Y _N 6 ~~:LSPACE
Does any part of the property lie within a special Flood designation area: _ Y ~
SEWER LfTIlITY /p
PROVIDER: ~rm ~
NAME OF lJT1LTTY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA I BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'5 (IF APPLICABLE):
Early Release
Permit:
o POST & BEAM
ErllAsEMENT ------
WALKOUT:_Y~N
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this permit is valid only if construction commence,s,
within 180 days of the date of issuance of the btpfE!PiP.~i5PJ1~ bpy~ ~~inKl of Occupancy issued) within 18 months of the
issuance date. Class I structure permits are subje~'tRthe eneral Adwln\stratiy+{tlu~~slM,'rt;J S.htfe'of Indiana (See 675 lAC 12) regarding expiration
tinltlfll\\IlM! li.f/6lJf6~'l~~&ff/PlaJji{~~!(QBlin .
I, the undersigned, agree that any construction, recon,s~.ru,~tio.&!fd~.~amRtQd:100!ib6;~~ation of a structure, or any change in the use of land or
structures requested by this application will COmPly~p~~~en4~l~~~m"" ' f Indiana, and the ~Zoning Ordinance of Carmel
Indiana -1993" (Z~289) and amendments, adopte a rity 0 C ~ [seg:GencrarAsse "the State of Indiana, and all Acts amendatory
thereto. I further certify that only kitchen, bath, atGtt ~~ "( ~ ~){itTr9>WrN.S UAer certify that the construction will not be
used or DeCll . d tII a Certificate of Occupancy has been Issued by ~WAent of COlYWInlty "Services, Carmel, Indlana
,diJ-e ..8"-<!'..s-/~7' 7. S:CJ~
Print /" Date
OFFICE USE ONLY: *************************~******~************~*3****~or****************
Filing Fees: / ,~ . 2.i
INSPECTIONS REQUIRED: '/1/'. 0 ('7 # Charged Re.
Base Inspections: _ _ __
Upper Footing Lower Footing Under Slab ReViews
Cert. of Occupancy: .53, ..:- iJ
~Ugh In) Meter Base
~Site
Reviewed/Approve :
S:Pef"mitsjForms!ILP RES
(Date)
P.R.I.F.:
~~ak~J?Ft~
Fee ~ceived by:
Additional Fees
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