HomeMy WebLinkAbout06070184 Application
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City of Carmel/Clay Township , ;Permit #:
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER of
RECORD:
I
ILl Ii- ,JI
317~ 7$3-0S(; G
cShck"7d /J/l(
FAX
PROPERTY
OWNER:
BUILDER'S EMAIL ADDRESS
Lok 84f.,-cj.~1/ foB 7
, I PHONE
L.- h 317-?5i -o5hfo
, CITY
ShEff cJ /oJ
STATE
fll
c/tOb 9
~. C QI)1
FAX
3t7-c!3'-/8-8t:,29
ZIP
"~06 9
STATE
IN
LOCATION
& PROJECT
INFO:
LOT #
SECTION
f) t) tJ
VJ,f3~
ZONING:
ADDRESS OF CONSTRUCTION \: /
./ - / W. 0/f10K.
SEWER UTILITY j. WATER UTILITY
PROVIDER: Sell C, PROVIDER: uJE 1/
NAME OF UTIlITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE):
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT:
o SINGLE FAMILY 0 NEW STRUCTURE
o TOWN HOME 0 ROOM ADDITION(S)
o TWO FAMILY 0 PORCH ADDITION(S)
# of units: 0 REMODEL
o MULTI-FAMiL.Y::'.',S?D F 0 ACCESSORY BUILDING Which plumbing codes will be applied to the construction:
# of Units;> . OR en"., I , S"'''';Ii~RAGE 0 I t t' I R 'd t' led II d' A d ts
O RESIDENTIAL' (Fe l(, Com"')! ~, \...I!JjI IpP)'l n ema lona eSI en la 0 e w n lana men men
or l~ I( lC(-l v.fill ATT.6, RAGE 0
Addition~ReltJod~lsjttG;)", ,[ (nn"";~ 8!i'I/"" frfjoos V:"^"7) 0 Unifonn Plumbing Codew/lndiana Amendments
C:,-, C~l n'r'I'~' -A~rQ.S J?/(uY'(IJ (Multl-FamllyConstrucllonCode)
PROJECT:fj;~A~''-.' V, ,"L';'ilTY ,~': ,~
, '-.d-l MEL Lf' .~,JlV8k FOUNDATION TYPE: (Checkallthatapplyforthenew
Early Release ,Ma/uit)irft.....d. ,
Permit: _Y _fNO/It~s~rvWNSHIfi' _N constructIon area)
o CRAWLSPACE
Lot Split: _Y _N Sump Pump: _Y _N 0 SLAB
Does any part of the property lie within a special Flood designation area: _ Y _N
PLUMBING CONTRACTOR:
,'-' WL
I, I
Plumber's India~2.t.ate License #: /
o
o
POST & BEAM
BASEMENT
WALKOlJT:_ Y_N
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this permit is valid only if construction commences
within 180 days of the date of issuance of the building permit, and must be completed (Certificate of Occupancy issued) within 18 months of the
issuance date. Class I structure permits are subject to the General Administrative Rules oC the State of Indiana (See 675 lAC 12) regarding expiration
time frames for beginning and completing construction,
I, the undersigned, agree at a y construction, reconstruction, enlargement, relocation, or alteration of a structure, or any change in the use of land or
structures requested by is ap 'cation will comply 'vvith, and conform to, all applicable laws of the State of Indiana, and the "Zoning Ordinance of Carmel
Indi -1993" (Z~ 9 and endmenrs, adopted under authority of LC. 36~7 et seq, General Assembly of the State of Indiana, and all Acts amendatory
then. o. ~tther tho only kitchen, bath, and floor drains are connected to the sanitary sewer. 1 further certify that the construction '11 not be
use r cupie unti a eTtilieat" of Oeeu ney has heen issued by rhe Department of Commjnj'Y Services. Carmel. Indiana,
D/R-AlF ( Srr/lth '7
Signature of Owner r Authorized Agent Print Da
OFFICE USE ONLY: ************************************************************************
Filing Fees: /33.6'0
INSPECTIONS REQUIRED: r.r. <"'" 0
Base Inspections: .;JQ..J
~~~r~~~: '?f(!). 00
Rough In
Lower Footing Und~
Meter Base Final ~
# Charged Re-
Reviews
Upper Footing
/07.00
P R I F . Additional Fees
..... ~
~ 10T~L: ~~oo ' ~
~;~--z:fO) 6 ~
Fee Received by: