HomeMy WebLinkAbout06070012 Application
City of Carmel/Clay Township Permit #:(5Coo7 DOl?..
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
ZONING;---=:-_
t' .....-- - '5:==- C:J
SQUARE . oil f'
_ ___ FOOTAGE: {,/07 S-r-
I -'.'~.h~-.
EsnMATEDCOSTOF:C9N~~uql6~ ~~ n \\/11"E'
(EXCLUDING LAND VAUUEjl r-'.~::' I-:'() 1Ji/O' IE; . , .
):! : f I (jl \.
1111,'1/ Iii
I I'"
Iii II JUL - .11
!)' II
PLUMBING CONTMCl'OR:
1RE LIFcsr;J;...Le hFoU P J.l>JC
Plumber's Indiana Statem:en-se #.
C'F' I DODO LLl:l
TYPE OF IMPROVEMENT:
o NEW STRUCTURE
/
(""& KUUM AI)Llamm~o
o PORCH ADDITION(S)
o REMODEL
o ACCESSORY BUILDING Which plumbing codes will be applied to the construction:
o DETACHED GARAGE eY'intemational Residential Code wI Indiana Amendments
,g'-AiTACHED GARAG'I o' . .
_ DEMOLITION . UnIform Plumbing Code w/Indlana Amendments
u~. . (Multi-Family Construction Code)
PROJECT INFORMATION: ,
Early Release M f ct . FOUNDATION TYPE: (Check all that apply for the new
_Y . / N T anu a u Y / construction area)
Permit: v russes: v N ..../
_ / - / l!1' CRAWLSPACE
Lot Spht: _ Y -Y-N Sump Pump: _ Y ~N 0 SLAB
Does any part of the property lie within a special Flood designation area: _ Y -/ N
BUILDER of
RECORD:
N~
ItlC Llr
It-.lC
CITY
..1/\J'/:> LS
STATE
nJ
BEST METHOD OF CONTACT:
(ant e nta.d
PHON~
C3\l)5i-j~-DD51o
PROPERTY
OWNER:
NAME
JER o/J I &U E
STREET ADDRESS
10M 3 C1Y-lR PDlT DR
STATE
IN
CITY
.4R>>1E:L
LOCATION
& PROJECT
INFO:
SECTION
LOT #
5
SEWER UTILITY
PROVIDER:
OINTDJ<.
WATER UTILITY
PROVIDER: Tl\llyf
NAME OF UTILITY EXCAVATION CONTRACTOR; PlAN COMMISSION I BZA I BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'5 (IF APPLICABLE):
TYPE OF CONSTRUCTION:
o SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units:
o MULTI-FAMILY
# of Units:
[if RESIDENTIAL (For
Additions, Remodels, Etc.)
FAX
ZIP
1-!&D3Z.
;j:
IIi
j.j
Ii!
ill.in
1""/'
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For Single F:~-&iOmafft~ibQQ.~SdJiUCrJ Is, and/or accessory structures, this permit is valid only if construction commences
within I80p;nfllJffd~t,,~mp*m:me ~~ kUilteggitatPottllmd must be completed (Certificate of Occupancy iSSUCdt'thin 18 months of the
issuance date~Crass r sarSttI, ftPetlercar~!~he General.Ad,ministrativc Ru ~es of the Stat~ of In~ia (~m' . 12) regarding expiration
. ..,.,FJryJ; 'i"l'/~~~mnmg and completmg cOI~~~ ' .
I, the undersi~egreGfit~MUN,h! rlc~ ~~i~.:...~iement, reloc.'ml' . ange in the use of land or
structures r~ntVl t"lF~~m~ 'fO~ to, all app~ \~ .' , f j'ana, and the "Zoning Ordinance of Carmel
Indiana - I99~\~~'28~ antr'amendru~ ed under authority of LC. 36~7 et se~n - ssembly of the State of Indiana, and all Acts amendatory
thereto. I further certify that only lftt~ , ,nd floor drains are connected to the sanitary sewer. I further certify that the construction will not be
used or cupied until a CertiH ate of Occupancy has been issued by the Department of Community Services, Carmel, Indiana,
~. 0'7'-""'" ~RSTEN J rv10RTON
Sign ure of Owner of thor ed Agent Print
I
OFFICE USE ONLY: ********* ***** ******* ************ ****** * *****;.~**>-"*Yfj******************
Filing Fees: 0'( ) - .5 (/
,INSPECTIONS REQUIRED: J /' /' _ <A # Charged Re-
~ _ Base Inspections: L-"" k> _ d U
pper Footina) Lower Footing Under Slab ( 6 Reviews
_ ~ Cert. of Occupancy: .,,- J 5
DnYi'gh In ) Meter Base ~ Site
C= __ P.R.I.F.:
"
.~<
o
o
POST & BEAM
BASEMENT
WALKOUT:_ y..LN
7/5/0&
D.", I I
Additional Fees
C /~ -/""
Reviewed/Appro ed: Dept. of Community Services (Date)
S:Permits/forms/ILP RESIDENTIAL