HomeMy WebLinkAbout06080035 Application
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City of Carmel/Clay Township Permit #: (Y(PO ~CO ~<
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICA'FION
For Single Family, Town Home, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
&. PROJECT
INFO:
SEWER LfTILITY
PROVIDER:
NAME: p (6 ~u.dt6()
BUILDER'S EMAIl ADDRESS:
NAME:
Qo.
PHONE: 4- 31 -d 7<-p 7
~ d CI1Y: tt t-e;rj
STREET ADDRESS:
lS~\
LOT #: SUBDIVISION NAME:
~sa
CJ.
STATE:
ZlP:rJ
ADDRESS OF CONSTRUcrrON:
15"?Jt
WATER UTILITY
PROVIDER:
PHONE:
BEST METHOD OF CONTACT: ~ II
FAX:
CIlY:
ZIP:
SECTION:
ZONING:
SQUARE
FOOTAGE: '71 ~
ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE)
..?:>i OX)
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA I 8PW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNlY WELL AND/OR SEPTIC PERMIT #'S (IF APPUCABLE):
FLOOD ZONE AREA DESIGNATION(S) V h eel' \ ---..1
FOR THIS PROPERTY: /\ k>7S . tfL",[ ~ 7 ""':'
lYPE OF IMPROVEMENT:
o NEW STRUCTURE
Cl!t ROOM ADDITION(S)
o PORCH ADDmON(S)
o DECK ADDmON(S)
~ REMODEL
_ Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION
lYPE OF CONSTRUCTION:
~
SINGLE FAMILY
TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions. Remodels. Etc.)
Early Release
Permit:
PROJECT INFORMATION:
Manufactured v
_ y 'Y.. N Trusses: Y '\ N ~ CRAWLSPACE 0 POST & BEAM _PIER
_Y ~N ~ Sump !S~UC1'O~ Y... N 0 SLAB 0 BASEMEN~ ,!!^!!~:,-'-... 1-N )
....c~.,j'- r I' C:::l(~''=''l'\V'''--~!J\1!
For Single Fami~,.iIll\dtT~trilOilit "d5r<<;!~, ~arti s ~odels, and/or accesso~ structures, this Pftvnf~s~d.~y ~.truction'~~teI1f';f within 180
days of the da~~~\DcitJle:QuUd~I?g PfF\IP.tC;til~h1~t9 ~t~~. (CertifI~ate of Occupancy~~sQ~1 }wt.tlim IS .mo?ths ,of the lssuflnce ~~e. ~Iass I
structure penmSeb~)ec~ tg\tfi!i,.Gen~KdWiP~~Q"-R..\'i 0 ate of Indiana (See 675 lAG 12)h;k mg exprratlOn tune frameS {Qt 1egmmng and
o r,~^\-.r\\.lN\ \ ('\\f'J\~ tingconstruction. 0r\r\h \ ~~
I, the undersigned~GY C<:n~c~ipn'flfCW1~l{cilih1e"nlargement, relocation, or alte . . YGngein1he4M'elbI lanq s~ I hues
requested by this aNllidtioE wiU-<:wQ\YJWir'h; lErl~CORform to, all applicable laws of .' a , t . coing O~dinance of Carmel lodi hi, Il 93" (Z-
289)andamen~~~Jm:Ici\~ut~R~ 116-7et seq, General A e ',b.'hli f.-ctsamendatoI:YsheIeto..-l.f~ercert that only
kitchen, bath, ancNB,\- drains are connect~B1ot e sanitary sewer. I . er c nstruction r' . I not'beused or occupied until a Certifica of
Occupancyhasbeeni ed by the Department of Co . y e . I. ndiana. _
B/1 /'OCL;
Date
Lot Split:
Qo~ Meter Base
P,R.I.F.:
TAX MAP PARCEL #:
PLUMBING CONTRACTOR:
G'OrctDf'\ u.. b
Plumber's Indiana State License #:
f() G. C( 3(p
Which plumbing codes will be applied to the construction:
o International Residential Code w IIndiana Amendments
i;li( Uniform Plumbing Code w/Indiana Amendments
FOUNDATION lYPE: (Check all that apply for the new
construction area)
**************
# Charged Re-
Reviews
Additional Fees
~\rOJ~ ft/SJ-r' x-Cf-06
Reviewed/Appr ed: Oept. of Community Services (Date)
S:Permits/FormS/ILP RESIDENTIAl