HomeMy WebLinkAbout06070050 Application
City of Carmel/Clay Township Permit #: r:roo '/Q05O
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
TYPE OF CONSTRUcnON:
~ SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units:
o MULTI-FAMILY
# of Units:
o RESIDENTIAL (For
Additions, Remodels, Etc.)
BUILDER of
RECORD:
PROPERTY
OWNER:
STREET ~330
BUILe.ER'S EMAIL ADDRESS
,)) WiC i.4 v J'
NAME n " /"
l'le/<-
STREET ADDi' I ({ 4
LOH 'iff
BEST MErnOD OF CONTACT:
PHONE
FAX
LOCATION
&. PROJECT
INFO:
ZIP
'It..D
ZONING: :;_____ /
TYPE OF IMPROVEMENT:
o NEW STRUCTURE
o ROOM ADDffiON(S)
o PORCH ADDffiON(S)
~ REMODEL
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLffiON
SQUARE
FOOTAGE: ;;25
( 6 00
- b <..
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!r.\ LS, \'~7 S L ",/ ,"':; i "I, ~ \
11 1\ .. _ ~-_ 1 \ \ \,
o 'w I oJ~L 1 3 2006 III ))1
Indian r License #: I L:::J i
Which plumbing COd.J-ill ~~ .PPIi.d_~...l'.'''On:~
o International Residential Code W IIndiana Amendments
o Unlfonn Plumbing Code w/Indlana Amendments
(Multi-Family Construction Code)
ESIlMATED COST OF CONSTRUCT1QN:
(EXCLUDING LAND VALUE)
, ,
NAME OF UTIUTY EX. All N CONTRACTOR; PLAN COMMISSION BZA / BPW DOCl<ET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPUCABLE):
PROJECT INFORMATION:
FOUNDATION TYPE:
Early Release L Manufactured L structi)
. con on area
Permit: Y . N Trusses: y' N
- - ~CRAWLSPACE
Lot Split: _Y~N Sump Pump: _Y LN 0 SLAB
Does any part of the property lie within a special Flood designation area: _ Y A.,N
(Check all that apply for the new
o POST & BEAM
o BASEMENT
WALKOUT:_Y_N
For Single Family and Two Family dwellin~[. W(~. (.')tl'ltaNccessory structures, this permit is valid only if construction commences
within 180 days of the Ae~~~ t, and,IT ~ completed (Certificate of Occupancy issued) within 18 months of the
issuance date. Class I st~t~~redm~bimt l~N~rnstrative Rules of the State of Indiana (See 675 lAC 12) regarding expiration
U . f ~ te a~{!f\...~nning and completing construction.
I, the undersigned, agree that any CO~~~<;1!;...r~9flsfm.tt~, SEI&cation, or alteration of a structure, or any change in the use of land or
structures requested by ~IKTti6illwi\LOoh\'plY"t9ith:and'co OJ:nll~~uable laws of the State of Indiana, and the "Zoning Ordinance of Carmel
Indiana -1993" (Z-2B9) ff, ~1eGWloYi WI'K!"~~f\leq, General Assembly 01 the State 01 Indiana. and all Acts amendatory
thereto. I further certify ~~~, ~~\I\~~4JSins are connected to the sanitary sewer. I further certify that the construction will not be
used or ~cu~til a CcrtifiCJlteo(Occupml~[~issued by the Department of Community Services, Carmel, Indiana.
..Jdf . ,,~:::- -1/11 /.krb/Sd>+J ~ )-I.3,tJ?
Signature of OWner or Authorized Agent Print Date
OFFICEUSEONLY:**********************************************!*****~'*****************
Filing Fees: / 73 3 ,) U
INSPECTIONS REQUIRED: 'J / ---0
. , Base Inspections: / G ~. 0 # Olarged Re-
(Upper F~ Lower Footing Under Slab ~ ..., ./ d Reviews
- @ Cert. of Occupancy: -...) ~. J
,ROugh In) Meter Base Final Site
~ P,R.I.F,: Additional Fees
~~ . ,-1-)4-tJ6 (,-/5:/ T~TAL: /!/7 /' "3)-.3. s-cJ
~\ ',.1 ( /;;:/~V~
Reviewed/Appro : Oept. ofCommunitySelVices (Date) -
\ S.PermIts/Forms/lLP RESIDENTIAL Fee Received by;
,