HomeMy WebLinkAbout06080018 Application
City of Carmel/Clay Township Permit #: tJf.tD 3 b 01'6
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER of
RECORD:
NAME
PHONE -} (J.
.5 5-rj'000
FAX 57 s-dtJ/tf
CITY STATE ZIP
.l,le J()6 XIJ 0) l.-
BEST METHOD OF CONTACT:
eOM {:-lJ#aI / dr Cell 3J -J:lOQ
STREET ADDRESS . J
I 29 s- 1'71 C'r/C;/-Il"'"
PROPERTY
OWNER:
NAME
STREET ADDRESS
LOCATION
&. PROJECT
INFO:
LOT #
l
~Amt.
PHONE
FAX
CITY
STATE
ZIP
SECTION
d'Z-.
ZONING:
PU.b
SQUARE"} 7Q
FOOTAGE:? I
ADDRESS OF C~NSTRUCT10N
Dro Will j-#-6AX 'lc.E' d-
WATERumLITY -r .JI /'/
PROVIDER: .J-IIIC{I C41tJofo lj
SEWER U11l1T1
PROVIDER: crt w
:zAJ ~~ p z.
ESTIMATEO COST OF CONSTRUCTION: .//')
(EXCLUDING LAND VALUE) r vO
dOn -
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
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION I BZA / BPW DOCKET
NUMBERS; TAC OATE(S); AND/OR COUNlY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE):
Manufactured FOUNDATION TYPE: (Check all that apply for the new
_Y LN Trusses: x..y _N construction area)
o CRAWLSPACE
Lot Split: _Y ~N Sump Pump: - Y -XN P'! SLAB
Does any part of ~~,,-rllP-,,-rty_I!~.~i!~i!,_'!...~e_<:ia~ Flood designation area: _y-XN
I' \ -~"' I
For SIngle FamIly arid jTwoJaImly dwelhngs, addJ.99!l~k.Viodels, and/or accessory structures, thiS permit IS vahd only If constructIOn commences
WIthIn I.i~a~ Rft!i~&t!d"f\SO~R:lJJa:ilt~I'mL and must be completed (CertifIcate of Occupancy Issued) WIthIn 18 months of the
Issuance ~~'flfruct1JfftcrnEWVirMt MfJ.kJtBmatiOO&1~ral AdmlOlstratIVe Rules of the State of Indiana (See 675 lAC 12) regardIng expiration
Sublect t9, c~rt;'~' ,...~I r:O~.framle's: for ,1;JegInmng and completIng constructIon
I, the unde~~igned, a~~~rk9!dtt:ioq, R~~lft1~luargement relocatlOn, or alteratIOn of a structure or any change 10 the use of land or
structures ~ MifF-~MVJ~~~t\N1!~~p.f..orm to, all applIcable laws of the State of Indiana, and the "Zonmg Ordmance of Carmel
Indiana::'-'I ~ 8.!'!~ ~e ~ d r:~N9t'l'ft:trofrC 36~7etseq,GeneraIAssemblyoftheStateofrndrana and all Acts amendatory
thereto r If;.r che'rf" a~ctn;~r drams ate connected to the samtary sewer I further certIfy that the constructIon will not be
used Upl until, h_as bce~fd by t D6'.;;-7- n:~U Catme!, Indiana 7-26--t:J6
ture 0 Owner or Authorized Agent Print Date
OFFICEUSEONLY:************************************************************************
Filing Fees: ~ I ?:;O
INSPECTIONS REQUIRED: 'rl
Base Inspections: ~ v # Charged Re-
CU;;;;er Foot~ Lower Footing k:,"..r Slab) 5 ~ c'.O ReViews
_ Cert. of Occupancy: .j "..:..J<<
~,nhT,2) ~rR"S~~ Si~ P.R.I.F.: / ~f . Of) Additional Fees
;;>.
TYPE OF CONSTRUCTION:
'0 SINGLE FAMILY
JZf TOWN HOME
o TWO FAMILY
# of units:
o MULTI-FAMILY
# of Units:
o RESIDENTIAL (For
Additions, Remodels, Etc.)
PROJECT INFORMATION:
Early Release
Permit:
Reviewed/Approved.
S:PermitsjFormS/ILP RESID
o
o
POST & BEAM
BASEMENT
WALKOIJT:_Y_N
(Date)