HomeMy WebLinkAbout06070027 Application
City of Carmel/Clay Township Permit #(JoD7DD:J1
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, lit Two Family: New Structures, Additions, Remodels, lit Accessory Structures
BUILDER of
RECORD:
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PROPERTY
OWNER:
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NAME, \.
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STATE
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BEST METHOD OF CONTAIT:
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STATE
ZIP
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CITY
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PROVIDER: ~ v V""""'\ e- \
TYPE OF IMPROVEMENT:
~NEW STRUCTURE
o ROOM ADDITION(S)
o PORCH ADDITION(S)
o REMODEL
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION
LOCATION
lit PROJECT
INFO:
ADDRESS OF CONSTRUCTION
\ ~ \-ro.:
Q.~'\D~
SEWER UTILITY
PROVIDER:
Co..v-
SQUARE IJ \
FOOTAGE: 5'1 '5
\ ~Ol OD
ESTIMATED COST OF CONSTRUcrrON:
(EXCLUDING LAND VALUE)
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA I BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'5 (IF APPLICABLE):
TY;-OF CONSTRUCTION:
SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units:
o MULTI-FAMILY
# of Units:
o RESIDENTIAL (For
Additions, Remodels, Etc.)
W \ \ '.';c v-, '-'J ","\--e. v ~ :x '-0~"
PLUMBING CON~~~ rs:.I#\066'i'll502S
S~ "0 (' lll.:4 ~=_~,=.{.l=;;..~ \. -, : ; . .
. '\ _n, I C\.c..:,o ~ _11,1\:
Plumber's Indian,LSfi'te License #: it! ;;;
'5?\DL,4 'B,4fu JUL 1 0 2006 Iii U:
'II Iii I" ,.,
Wh, plumbing COdes'WiU~gl~ed to the construction:; l:::./ j
~ International tSidential Code w/India~a A~endmerts
o Uniform Plumbing Code w7Ii1diiina-Am'endments---'
(Multi-Famiiy Construction Code)
PROJECT INFORMATION:
Early Release / Manufactured /
Permit: Y Z Trusses: ../ Y N
~ 0 CRAWLSPACE 9". POST & BEAM
Lot Split: _ Y N Sump Pump: "'-- Y =N 0 SLAB '-ll BASEMENT
Does any part of tlal:ilr~~i od designation area: Y LN WALKOlJT: y-LN
For Single Family an T~o FaJfnf~{~.caa<'tritbnaJt~}jt~r accessory structures, this permit is valid only if construction commences
within 180 days of the date oPfs:smta ahdi~~' t, an~t'mt.~t be completed (Certificate of Occupancy issued) within 18 months of the
issuance date. Class GdDl?c1ir~t(g~MP.J~~ll t ~ oeral Administrative Rules of the State of Indiana (See 675 lAC 12) regarding expiration
CITY nJ:' r6b tMi~ a M gGCSandcompletingconstruction.
I, the undersigned, agree iha't'tny't:t@:#t:lM6h. ~~t~~elocation, or alteration of a structure, or any change in the use of land or
structures requested by this application wVMEJl1X't..j\~th, and conf'a~~, W-;pplicable la\vs of the State of Indiana, and the "Zoning Ordinance of Carmel
Indiana - 1993~ (Z- 289) and amendments, adopte'Ci.'t~ah authority of LC. 36~7 et seq, General Assembly of the State of Indiana, and all Acts amendatory
thereto. I further certify t at only kitchen, bath, and floor drains are connected to the sanitary sewer. I further certify that the construction will not be
r occu 'ed until a nea.teo 0 eupa.fleyhas been issue by the D artment of Co munity Services, Carmel Indiana.
~
Date
FOUNDATION TYPE: (Check all that apply for the new
construction area)
Print
OFFICEUSEONLY:************************************************************************
Filing Fees: OJ ,}f-/ e
INSPECTIONS REQUIRED: / '
Base Inspections: ;;l11, S () # Charged Re-
,.. ReViews
::)'-:.;.:}'O
00
d-Jdb, /0
P.RJ.F.:
Cert. of Occupancy:
Additional Fees
t:.'vY>-\~I'$~O~( 7-ll-nb
ReviewedjAppr ed: Dept. of Community Services (Date)
S:Permits/FormsjllP RESIDENTIAL
Fee Received by: