HomeMy WebLinkAbout06070014 Application
City of Carmel/Clay Township Permit #: O~ (;)')00 ,'-(
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER of
RECORD:
STREET ADDRESS
l"oW.~
PHONE FAX
LL~ bI1-11~-qq.j3 31r;-/7~-qqL(,/
CITY STATE ZIP
No e5!.v:/le.. / I\J L./vO<.1?O
BEST METHOD OF CONTACT:
~ ~(J;6.
LOCATION
& PROJECT
INFO:
FAX
PROPERTY
OWNER:
-"'1')'70
STATE
1/0
ZIP
4LtO
SE~N
ZONING:
S -/
'o..J)
SQUARE 9JI
FOOTAGE: 0 '1
SEWER UTJUTY
PROVIDER:
ESTIMATED COST OF CONSTRUcnON;
(EXCLUDING LAND VALUE) q::. ~
()
I
NAME OF UTJUTY EXCAV ON NTRACTOR; PLAN COMMISSION I BZA I DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'5 (IF APPLICABLE):
!:"r-o,
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT: PLUMBING CONTRACTOR: ~\
.10 0~
o SINGLE FAMILY ,., if;' ~ NEW STRUCTURE \\. - <<.:" '\
8 ~~NF~~I~~ V 0 ROOM ADDmON(S) -\~ Plu~ber's Indiana State ~ ~\~J7\
o PORCHADDmON(~A\\\Jl(('9D . -~a=~~~ '
# of units: 0 REMODEL . 'tt:" " ~ ,
o MULTI-FAMILY M ACCESSORY BUILD! "WhiCh plumbing cOd,esWIII ~jpplied to the constNlliion:~
# of Units: \\ 1"... Co '~\Jv-
~ 0 DETACHED GARAGE 0 International Re i ~ial CO~Jinlfiana Am~ ents
RESIDENTIAL (For 0 \ \\ \\ ./'
Additions, Remodels, Etc.) ATTACHED GARAGE 0 Unifonn Plumbi~ w/!h iana Amen8ments
o DEMOLmON (Multi-Family const~' : ,0 ~ode) ~
PROJECT INFORMATION: ~) '\..-./'
Early Release Manufactured FOUNDATION TYP : (Check all apply for the new
Permit: _Y)51N Trusses: _Y LN construction area)
p. CRAWLSPACE
Lot Split: _ Y ----i.N Sump Pump: _ Y X-N N SLAB 0
Does any part of the property lie within a special Flood designation area: _ Y LN
POST & BEAM
BASEMENT
WALKOUT:_Y_N
For Single F. amily and Two Family dwellin~..a?.Q-itio~s,~pM~ and/or accessory structures, this permit is valid only if construction commences
within 180 d~j!tt!:AeE{)sfi@R €~iliiit~-In'~ must be completed (CertiHcate of Occupancy issued) within 18 months of the
issuance date. .....SUibt"st~toUEfcRfilSlf~~s.Wt;~~JPlQbg~a.dministrativc Rules of the State of Indiana (See 675 lAC 12) regarding expiration
U Jec , rl LOc~Ord~~ for beginning and completing construction.
I, the undcJ;"sigm;:d, agree thW ~~~RJt:non, r~~s~tri\\n,li;AI~mcnt, relocation, or alteration of a structure, or any change in the use of land or
structures reque~'mQ~i6G9MMl:H'H~IY l..i~~li1IY:6hf'6rm'to, all applicable laws of rhe Srate of Indiana, and the ~Zoning Ordinance of Carmel
Indiana -1993" (Z~ tA.4-alfl'Ci\.~JA~pdifl~ti ~e1["<{G):WNSHlP36~7 et seq, General Assembly of the State of Indiana. and all Acts amendatory
thereto. I furrhM t y~.rr ~~l::~.?ry~ft;..li... ~q.:d Moor drains are connecred to the sanirary sewer. I further certify that the construction will not be
used or occupied until a Certificate ~}ftJr has been issued by the Department of Community Services, Carmel, Indiana.
~ Tv.\. ~ Su.Sa-r\ tXCA.m 0/ulOlt
Signature of Owner or Authorized Agent Print Date
OFFICE USE ONLY: ** **** ************ *** **** *.~****** ******* * **** *~~~*~(j********************
Filing Fees: 2f...U'
. INSPECTIONS REQUIRED: / / / _ 6' 0 # Charged Re-
..<.::: Base Inspections: _ b '"
lupper Footinv Lower Footing Under Slab -:- 3. --'0 ReViews
_ Cert. of Occupancy: v J'
rRough I.,) Meter Base ~ Site
~ P,RJ.F.:
_ AOTAL: !:JtfrJ ,(N
7~~>>bi1i-~
Additional Fees
Fee Received by:
Reviewed/ App ved: Dept. of Community Services
S:Permits/FormS/ILP RESIDEflITIAL