HomeMy WebLinkAbout06070033 Application
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City of Carmel/Clay Township) Permit #Qkf1 [f) 33
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER of
RECORD:
NAME -~D 4-
"=._,,...1D <;.
t-+oM6S
C<.,)~\OM
PHONE
FAX
915"-2.512-
c'&:i - 8530
STATE
ZIP
4(,.0 TZ-
STREET ADDRESS CITY
14~co C-L-AY "T€RI'''-<i: ,:;-"p
BUILDER'S EMAIL ADDRESS
<:..A~L
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BEST METHOD OF CONTACT:
llZ..-.M.tI-\ l
O&-J<?-'l f ~ e.s~J<f.' "....:t
FAX
PROPERTY
OWNER:
NAME
rI-o...." ~
&>TRn:>4€ .:." So"''''''
STREET ADDRESS
PHONE
CITY
STATE
ZIP
LOCATION
So PROJECT
INFO:
LOT #
40:'
SUBDIVISION NAME
V,LLA4G" of'"" \.JEST <..r...A Y
SECTION
/1/; 01-.
ZONING: 0
IVY
ADDRESS OF CONSTRUCTION
I , -f 3 I1Rov<; /flb,J >-,.
SEWER UTILITY C<.A Y
PROVIDER: fi.,...,...._.b.- <
WATER UTILITY
PROVIDER: CAJltAC~
c.A.l2.rlel...., \,J
SQUARE
FOOTAGE: foOl LJ
4>~ .j/~. ooD
ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE)
N COMMISSION / BZA / BPW DOCKET I'd ~
ND/OR SEPTIC PERMIT "S (IF APPUCABLE): I v\erri" '1M
"* ob07oo:3/
o
F IMPROVEMENT:
NEW STRUCTURE
ROOM ADDITION(S)
PORCH ADDITION(S)
EMODEL
ACCESSORY BUILDING
DETACHED GARAGE
ATTACHED GARAGE
DEMOLITION
o
PLUMBING CONTRACTOR:
f<\~.:o~
Plumber's Indiana State License #:
100 :)-z.c
Which plumbing codes will be applied to the construction:
,J2f International Residential Code wI Indiana Amendments
o Uniform Plumbing Code wI Indiana Amendments
(Multi-Family Construction Code)
FOUNDATION TYPE: (Check all that apply for the new
construction area)
Manufactured
_Y -X-N Trusses: ~Y_N
o CRAWLSPACE
Lot Split: _ Y -X-N Sump Pump: ---$- Y _N 0 SLAB
Does any part of the property lie within a special Flood designation area: _ Y LN
o
(Z9:
POST & BEAM
BASEMENT
WALKOUT:_Y~N
For. Si?gle Family and T, w.o Fami,!ydweni!)g~'l.qQ.t~, ~~nd/or accessory structures, this permit is valid only if construction commences
Wlthm 180 dayfrEt,elMS 8fi).sliiGilBoukJ rMitMitig'P~Xtp1t;1n must be completed (Certificate of Occupancy issued) within 18 months of the
issuance date. Cl~~b~ltft\ft&,tB~t\.~auh)tb: aUt~!d ministrative Rules of the State of Indiana (See 675 lAC 12) regarding expiration
Su lec , and LoclWOomusfor beginning and completing construction.
I, the undersigned, agree thaPl~t&mtructi(;IOI,t~J~~~mt\~m~ent, relocation, or alteration of a structure, or any change in the use of land Of
structures requestel[l' ~cG6iH\I~l9b\:tnylW:itPt'ana 'co~rp81~.Hptll applicable laws of the State of Indiana, and the "Zoning Ordinance of Carmel
~ Indiana _ I993~ (Z- r}'!.~Wm~Eco~~r roW~J.c!:&.'36-7 et seq, General Assembly of the State of Indiana, and all Acts amendatory
thereto. I furtherGJ f t~orrWt<1t~ en, . bar drains are connected to the sanitary sewer. I further certify that the construction will not be
used or occupied until a Certificate o1\bt a as been issued by the Department of Community Services, Carmel, Indiana.
\ /Zv1L G...- ~~~ O-=J th/O~
~ignature of Owner or Authorized Agent Print Date
'~ICE USE ONLY: ** ******************* *****'~*******************r::**** *,';-f******************
\ FIling Fees: _CZlJ, 'J.U '
\ INSPECTIONS REQUIRED: > "'11 /71 :
\_ Base Inspections: d-- 2 _ :5 v # Charged Re-
\, Footin~wer Footinv Under Slab ./ ,n') ReViews
\ ~ ~ Cert. of Occupancy: :2-5 - ~
'\ ~ ~al ~ P,R.I.F,: t Ii h {. 9,0 Additional Fees
\ ' 7lJ{treJ- ;/0
<I~.-"'f' 7-1'?.-().{, --; p-~
Jept. of Community Services (Date)
.J1DENTIAL