HomeMy WebLinkAbout06070191 Application
City of Carmel/Clay Township Permit #: Oluo1!J 1t11
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER of
RECORD:
NAME
PHONE
PROPERTY
OWNER:
e
STATE
ZIP
STREET ADDRESS
v<:.J'-..f+. or VI.
n
BEST METHOD OF CONTACT:
.s; , 6'n<[(
NAME
8
FAX
2 -'r-:;)iPj'
ZIP
c{6z$"Z)
ZONING:
5-/
LOCATION
&. PROJECT
INFO:
STREET ADDRESS
Ce0le~
LOT #
l/~
STATE
e:
PI.
d
( D- C-f;
SEWER UTILITY OleO'l 01 q-o ESTIMATED COST OF CONSTRumON:
PROVIDER: e (EXCLUDING LAND v1'lU!L.._ _3 90/ () 0 <7
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA I BPW DOCKET J i ! f\ \ U~. (r-;: rs; In ~\ ,--,'7 -rt;;-''::~~:'', ]
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'5 (IF APPLICABLE): VJ 1/5 (J ~ IJ!!.I ,I) I -"-'::::~:J ~ J .f~ :';::';J, {!1 '\ i
TY~F CONSTRUCTION: TYPE OF IMPROVEMENT: PLUMBING CONTlikdrbR: J 11/' Ji}1
SINGLE FAMILY ~ NEW STRUCTURE ~"(6 6.l4~JL c.f:JW~ 3 1 2006 .1 i I
is ~~NF~~I~~ 0 ROOM ADDITION(S) Plumbe~~ Indiana ~~e~License.1t: -.J U:::J I
# of units: 00 PORCH ADDITION(S) " /0 b lJi-.o ,0 - . I
REMODEL _}
o MULTI-FAMILY 0 ACCESSORY BUILDING W~iCh umbing codes w;U be applied to th;,C:onsffifctIon:_
# of Units:
O 0 DETACHED GARAGE ntemational Residential Code wI Indiana Amendments
RESIDENTIAL (For 0 ATTACHED GARAGE
Additions, Remodels, Etc.) 0 DEMOLITION
SUBDIVISION NAME
sEmON
)
SQUARE
FOOTAGE:
G6tl
o Uniform Plumbing Code w/Indiana Amendments
(Multi-Family Construction Code)
PROJECT INFORMATION:
Early Release ~ Manufactured ./
permit:. _ Y :::"Dl Trusses: v'Y N
/.. ~ 0 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
FOUNDATION TYPE: (Check all that apply for the new
construction area)
o Pg>f & BEAM
~ASEMENT
WALKOUT:_Y~
For Single Family and Two Family dwellings, additions, remodels. and/or accessory structures, this permit is valid only if construction commences
within 180 daysFf~~'!i~iM~f~tYJ4ipg,pll~ ~d must be completed (Certificate of Occupancy issued) within 18 months of the
issuance clate. CI~lb~fti~~~i~[re'M1bJ~~~~JW.N.ministrative Rules of the State of Indiana (See 675 lAC 12) regarding expiration
U j6CttO corppllance ~ mllireglJtchipnsing and completing construction.
1, the undersigned, agree thaof~tatetMd~EO~~, enlargement, relocation, or alteration of a structure, or any change in the use of land or
structures requesEfle pir. ~~E~Yr\JtJ".tl?-~~CW.'qIj1D,.tr, all applicable laws of the Stare of Indiana, and the "Zoning Ordinance of Carmel
Indiana -1993" (~ ana amend'n1e,{I" JndeH.6tfi!,M~f:I.~. 36~7 er seq, General Assembly of the State of Indiana, and all Acts amendatory
th~reto. I furthe i thlF01(i;ft.EaMiCbt ~OOWftORH:fIP.ted to the sanitary sewer. I further certify thar the construction will not be
used or occupied until a G nilkate 0 fl.J'Ahas been issuedby 'tb~ Department of Cnmmunity Services. Carmel, Indiana. ~ ~
(' t~1 --:{kV<1sLJr -;7, 31 6 b
Signature of Ow r or uthorized Agent Print I Date
OFFICEUSEONLY:******************************************************~,~***************
. Filing Fees: / (} 3 !" w
\'_ INSPECTIONS REQUIRED: ' -, 7 7. ,:-0 # Charged Re-
- Base Inspections: ~ _ _ J
.,.uope,rr F Foooottiinnag --, _ Under Slab ,Reviews
\~ Cert.ofOccupancy:.) ]. TO
\R~U9~ Final I ,}.. {-, l ()()
63
<(.1-0
Additional Fees
'~ppro d: Dept. of Community Services
'S/llP R SIDENTIAl
\
(Date)
,
-'7--06