HomeMy WebLinkAbout06060191 Application
'"
City of Carmel/Clay Township Permit #: a()~()!qJ
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER of
RECORD:
NAME /7 .. <" PHONE
L-<>/J.5"1'~uc.:no..) ..Jd4J;cf> 11S$cc.
CITY
~5>' j)~ 5,c;ISb
FAX
.5/7- 407-0127 .?17-S75""":"S5b5"
ZIP Ll."O
~z~
STREET ADDRESS
.Y9"z.Y j2':iE/L
BUILDER'S EMAIl ADDRESS
C4 ;)1l::I<MA,..u.€ Sac...
PROPERTY
OWNER:
NAME
~ ALLc.eL
STREET ADDR~S~ _ -;7
t:.aJ3 WP Ire: PliZb-t '2)12.-
LOCATION
& PROJECT
INFO:
LOT #
SUBDIVISION NAME
Vi.
liD
ADDRESS OF CONSTRUCTION
/Z/s,z TG:4L
SEWER UTILITY .
PROVIDER: (!.:t/2..J D
STATE
=Z-.,..)
BEST METHOD OF ONTACT:
aI_nc:f e.rM.3<f i:>fL
7 -"01;...7
PHONE
FAX
fJ 438
SECTION
ZONING:
SQUARE
FOOTAGE:
RumON:
3t"Z Zl.bO. cro
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION I B BPW DOCK
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT
TYPE OF CONSTRUCTION:
)8r SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units:
o MULTI-FAMILY
# of Units:
o RESIDENTIAL (For
Additions, Remodels, Etc.)
CTOR:
5",...:th
a State License #:
101777
TYPE OF IMPROVEMENT:
)(r 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 / Manufactured /
Permit: Y V N Trusses: Y V N
~ --;7 0 CRAWLSPACE
Lot Split: Y -'L-N Sump Pump: ~ Y =N >> SLAB~4.A"':::
Does any part of the property lie within a special Flood designation area: _ Y
Which plumbing codes will be applied to the construction:
o International Residential Code wI Indiana Amendments
KUniform Plumbing.Code wI Indiana Amendments
(Multi-Family Construction Code)
FOUNDATION TYPE: (Check all that apply for the new
construction area)
o POST & BEAM
BASEMENT
LKOUT:_Y -KN
For Single Farui)~\ln.d I)X.q.f.aJ1l.il~e~.twl:-i,AA4ieR~~e' and/or accessory structures is permit is valid only if c nstruction commences
within 180 d~J:;:Of.~~1et ~Mlil:J,;d!-~QH;;bh8h'rf.~ ,a d must be completed (Cert. icate orOe up' cy issued) w thin 18 months ohhe
issuanc.e date. BlikJjt~~OOfl1tP'~_~~\ijeWlt6&fl~m! Elf Administrative Rules of t State of I='l~:;!s 75 lAC 2) regarding expiration
.'.. 01 State and ,Loca~6e6:eS\es for beginning and completing co -truction. 1:11
I, the undersig~'1'" ~~1"'R~~1ft;MI~~R~~ement, relocation, or altera 'on of a stru ,any ch e in the use of land or
structures reque~6YlhW'.!P~~'J!~\\ltlt'col!tpli' ~\l1't~~r;.,~ 'copW~o, all applicable laws of th tate -I Siana, and oning Ordinance of Carmel
Indiana - 19930l'Pi90fKI~Mml41"i>l<:.!'tlf1dT""",~llllql'illJlC. 36-7 et seg, General Assembly of die S ndiana, and all Acts amendatory
thereto. I further certify that only ki~~qQJ,t{Id floor drains are connected to the sanitary se\vcr. If er certify that the construction will not be
used or occupied until a Certific3.tlbrempancyhas been issued by the Department of Community Services, Carmel, Indiana.
C,A ~ U- ~ 1>' 0-r-4 By (1=" ;;>;e~.,J,..J rb (2? I()~
Signature of wner or AuthOrized Agent Print Date
OFFICE USE ONLY: *********** ******* *** **** *** ********* ********1J;.*!!lF.*********************
Filing Fees: & s ;;2.... '7 ()
INSPECTIONS REQUIRED: ""-; -, .,--" # Charged Re-
Base Inspections: cY / ~ LY
ReViews
Cert. of Occupancy: --.:>.3 - 5""6
P,R.I.F,: I c:2- C I () () Additional Fees
~~~6f/://1J
Fee RecelVed by:
,I';;;.~ . . 2f'-06
ReviewedjA proved: Dept. of Community Services (Date)
S:Permits/FormS/ILP RESIDENTIAL
-;
'~ ,-
'G.'.I'
'W"
o
. ,,\'\.
t: 'jl\.";'''
"