HomeMy WebLinkAbout06060141 Application
City of Carmell Clay Township Permit #: {)ep O~ 0/4 I
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER of
RECORD:
NAME C
~S~
STREET ADDRESS
PROPERTY
OWNER:
BUILDER'S EMAIL ADDRESS
CAst (ejlll ,tA,t4,~
('~" It-l'''V4''~''''
. (.bM
STREET ADDRESS
11013 Bra ~
c+.
LOCATION
&. PROJECT
INFO:
LOT # r SUBDIVISION NAME
~ 0fO~
ADDRESS OF CONSTRUCTION
SEWER UTILITY
PRovmFR'
(
~~~I;c.re
'~Ol~ B(Il""k
.-WAIER.1JllLIT'l ~~_
QVInFR' ~~ _ /I
PHONE
- 2' 0 0
FAX
1'1/,- '2-" I
CITY
rlVttL
STATE
IN
ZIP
La ()'n_
BEST METHOD OF CONTACT:
WI ~p"L' S-n 'H~
PHONE
l11,,-2q,~
FAX
CITY
STATE
J-tJ
ZIP
4'03"2---
....L i..-
SECTION
_ZONING:
(
n
SQUARE
FOOTAGE: l?otl
ESTIMATED COST OF CONSTRUCTION: Jr
(EXCLUDING LAND VALUE) :II' ~3, 0 DO. PO
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION I BZA I BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'5 (IF APPLICABLE):
TYPE OF CONSTRUCTION:
o SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units:
o MULTI-FAMILY
L. # of Units:
)I\J RESIDENTIAL (For
Additions, Remodels, Etc.)
PROJECT INFORMATION:
Early Release
Permit:
Lot Split:
_YB
_ Y t-f(./
TYPE OF IMPROVEMENT:
o NEW STRUCTURE
o ROOM ADDITION(S)
o PORCH ADDITION(S)
jE.' REMODEL
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION
Manufactured
Trusses:
_yV;
_y~.
o CRAWLSPACE
o SLAB
- I Flood designation area:
Sump Pump:
PLUMBING CONTRACTOR:
~I P~~3b ~ Sc~vl~r
Plumber's Indiana State License #:
PII/""~I~
Which plumbing codes will be applied to the construction:
o International Residential Code wI Indiana Amendments
o Unifonn Plumbing Code wI Indiana Amendments
(Multi-Family Construction Code)
FOUNDATION TYPE: (Check all that apply for the new
construction area)
o POST & BEAM
(B""'"BASEMENT
Y ~.- WALKOUT:
c:..--:;.
Y N
For Sin8f\)~dom~n8'1d.edWtlliiaMsregtJl:att0,nsmodels. and/or accessory struct~res, this permit is valid only if construction commences
within 180 Haysef Bfafetal1'dSf.~f efcS~ilding permit, and must be completed (Certificate of Occupancy issued) within 18 months of the
issuance date. g~.l.s~~l1tft."Qt;rroi,t,s,a[; ~~ts\ ,~~eneral.Ad.ministrative Ru~es of the Stat~ of lndjana (See 675 lAC 12) regarding expiration
t;)EPT Ur vUMIVIUl\ll1 T \:)'tihkVfHn1~qorbegmnmgandcompletmgconstructlOn.
I, the uem~0AA~~VnJ@WNSlrHRnIargement, relocation, or alteration of a structure, or any change in the use of land or .
structures requested by this a .' i v>>I comply with, and conform to, all applicable laws of the State of Indiana, and the "Zoning Ordinance of Carmel
Indiana -I99r (Z~289) and a e t. !idopted under aurhorityof r.c. 36~7 et seq, General Assembly of 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
use or occ Ie nul a CertIncate of Occupancyh" heen Issued hy the Depart~ent of Commumty ServIces, Carmel, IndIana,
. ffid.,~L-- t:1(>t1t S fol'LOld~
Signature of Owner or Authorized Agent Print Date
OFFICE USE ONLY: **************************~*******************~~*~***>\****************
Filing Fees: / 2 ~ J (/
INSPECTIONS REQUIRED: Y/I. {f0' # Charged Re-
Base Inspections: 6 _-
Upper Footing Lower Footing Under Slab , ' C 2>, s- () ReViews
~ Cerl. of Occupancy: ..-'
R;';;~In Meter Base (final Site)
~ ;::7 P.R.I.F.: Additional Fees
~__@lAL: I. $C?f?OO
~_ I ill ~ 7-S:-0{o
Fee cei d by: L
,.
..:~t:{ .
.J
.Z'7-06
(Date)
Reviewed/Approved Dep. of Community Services
S:Permits/FormS/ILP RESI ENTlAL