HomeMy WebLinkAbout06070049 Application
I
City of Carmel/Clay Township uJ .c,~ Permit #: OcOO'(Q0Li1
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER of NAME R '1 (lI~K LIlN'SrUJ.cnO/J PHONE 1-f110-t;Q/l FAX
RECORD:
STREET ADDRESS ' CITY STATE ZIP
1'it..~ 6om.a~ET ~I\-I.\ :IN'b I MJ f\P 0 L-\-:> ;DJ "'Ii, l..'i D
BUILDER'S EMAIL ADDRESS BEST METHOD OF CONTACT:
PROPERTY NAME PHONE FAX
OWNER: C'... JO'5eP H Q.u. ~s E1.i. 'jt-lg -59&' 2..7...:3 - () Z-2!l
STREET ADDRESS CITY STATE ZIP
550'8 ~t cmtm fl 1)/1..1 vt: ~eL zi:.tU /f{,o33
LOCATION LOT # SUBDIVISION NAME SEmON ZONING:
& PROJECT 5'1 ~ 1) E1'-l 1;5 n+T t:S :!L ~-I
INFO: ADDRESS OF CONSTRumON SQUARE 41,,'-(
- 5Amt - FOOTAGE:
SEWER UTIlITY .1 WATER UTILITY ESTIMATED COST OF CONSTRUCTION:
PROVIDER: c.. ''f\.I Of- U\{l1l1 c\... PROVIOER: t.11'Y Or cMMfOL (EXCLUDING LAND VALUE) 1> 2 ~I 0 0 6
NAME OF lJTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA I BPW DOCKET rJ / A 1':;I~:;-(;:::':~fc:-;rl\'Ji I~i:i':~'\
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'5 (IF APPLICABLE):
,'-- ""'..> '. ""-" '.
:', . '-''''-'' ,"'"'' ,~~:':;:; d ," "' - ,
\ TYPE OF CONSTRUCTION:
0 SINGLE FAMILY 0
0 TOWN HOME 0
0 TWO FAMILY 0
# of units: 0
0 MULTI -FAMILY 0
# of Units: 0
ra RESIDENTIAL (For g
Additions, Remodels, Etc.) 0
Which PlumbingCode,- .' .' .'''_. ied to the construction:
o International Re'Sitfe-ntlarCO'de wI Indiana Amendments
o Uniform Plumbing Code wI Indiana Amendments
(Multi-Family Construction Code)
PROJECT INFORMATION:
Early Release
Permit:
M f ct d FOUNDATION TYPE: (Check all that apply for the new
T anu a ure Y / N construction area)
_Y _N russes: file; v
nsI.EASt::I"\A<- 0 CRAWLSPACE 0 POST & BEAM
Lot Split: _Y ~N Sump pU"""bl~~..'!':..t~R CO)j@;TRtJl 0 BASEMENT
Does any part of the property lie within a speciall::lPS l!l!1611Iil1iWlt,,~. CTlQ~N WALKOUT: Y N
For Single Family and Two Family dwellings, a4;iiWIls, e &"eC@AkKm:lt,~~~S&res, this permit is valid only if construction commences
within ISO days of the date of issuance of the $'ddi,.gGI:mM.A~ri~~'H~~~~t'f~.2fOCcUpancy issued) within 18 months ofche
issuance date. Class r structure permits are subject to th; Gen~'AOO/ias1)~eRt)I t ~~ Indiana (See 675 lAC 12) regarding expiration
time frames for beginnllW!J1cJ.. m-plt!i ~rD
I, the undersigned, agree that any construction, reconstruction, enlargement, rml:Yt1\n, or alterati~~7;t a'~tiucture, or any change in the use of land or
structures requested by this application will comply with, and conform to, all applicable laws of the State of Indiana, and the "Zoning Ordinance of Carmel
Indiana - 1993" (Z~ 289) and amendments, adopted under authority of LC. 36~7 et seq, General Assembly of the State of Indiana, and all Acts amendatory
thereto. I further certify that only kitchen, bath, and floor drains are connected to the sanitary sewer. I further certify that the construction will not be
usedoroc::~~t~c~r~ccUpanCYhaSbeeni:;.t~;:;t;:Of~m~e:;~~rmel'lndi.n. 1 J 1310&
Signatur of Owner or Authorized Agent Print Date '
Meter Base
INSPECTIONS REQUIRE
Lower Footing
**~******~**** **************/**~.*c**~~*****************
. (J-lh FIling Fe s: _9 1- / r.1
: d "Bas nspections: / h 0. :f 0 #Charged Re-
der SI b 1/1'{ ') '/: } ReViews
V. 'ert, of Occupancy: )' 3. .) c.
P R~F . Additional Fees
. 7 -)5-0{ , '... T~ f 1e 1 (l
(Date) ~-
Fee elved by:
OFFICE USE ONLY: *************
itJ~
Reviewed/Approved: Dept. of Community Services
S:Permits/Forms!IlP RESIDENTIAL