HomeMy WebLinkAbout06080011 Application
City of Carmel/Clay Township Permit #: 0('" 10 q 00 II
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER of
RECORD:
PHONE
5'02- 0\'\0
FAX
S-8 l-q V1'Z...
STREET ADDRESS
2..2
c\
CI1Y
~'I"'\--e\...
STATE
~
ZIP
03~
BUILDER'S EMAlL ADDRESS
BEST METH9I( OF CONTACT:
l(Nsf\ Q ,
'\,
PROPERTY
OWNER:
NAME
\)fW<Q.( S~,.{"e.. \\~
'2..6
STREET ADDRESS
\l,\~~
CI1Y
STATE
~
FAX
3\'1-l-'31-'/s'32<O
ZIP(,03 2-
ZONING:. \ , _ !
02.S' 0el\,~CI-\
c.&.-\'rY\ Q. '--
LOCATION
&. PROJECT
INFO:
LOT# b
SUBDM$IQN NAME
(0J\'ft'. 'Q..U.oJooO
SEmON
~~'\:)~A- t.{~;2..,.
SQUARE
FOOTAGE: I S"3 Y
SEWER UTIUTY WATER UTIUTY
PROVIDER: ~.(~ PROVIDER: Cc>-r<W>L..
...,-'\ .
NAME OF UTIUTY EXCAVATION CONTRACTOR; P.LANWMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTf-WSU.'ANOlOo\SEPTIC PERMIT #'S (IF APPUCABLE):
\~r '
TYPE OF ONSTRU G "', ~J V"TY MPROVEMENT:
aI SIN~~q~];~;;':"?~"> - STRUCTURE
8 ~~~~~ .. '1 '))l~~ ADDmON(S)
# ofh~~\ ~\\~ :~DmON(S)
o MULTI-'~~~I~\ 0 A CESSORY BUILDING
# of Un\~i \ --6 DETACHED GARAGE
o RESIDEN1\IAL ( or ..----- 0 ATTACHED GARAGE
Additions, 'em~s,-B:n 0 DEMOLmON
PROJECT INFOI\MATION:
Early Release
Permit:
o 1J:fJ
PLUMBING CONTRACTOR:
Plumbers Indiana State License #:
Which plumbing codes will be applied to the construction:
o International Residential Code w/Indiana Amendments
o Uniform Plumbing Code w/Indiana Amendments
(Multi-Family Construction Code)
FOUNDATION TYPE:
construction area)
1j!I'I'. 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
_Y_N
Manufactured
Trusses:
_Y~N
(Check all that apply for the new
o POST & BEAM
CJ BASEMENT ~
WALKOur:_ Y----,-N
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures. this pennit 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 of the State of Indiana (See 675 lAC 12) regarding expiration
time frames for beginning and completing construction. ~. ~;
I, the undersigned, agree that any construction, reconstruction, enlargement. rdocadon, or alt.n BI... g'. . Jand or
structures requested by this application will comply with, and conform to, all applicable laws 0 \ te., e of Carmel
Indiana - 1993" (Z~ 289) and amendments, adopted und . of LC. 36,7 et seq, General Ii:. 0 . ana, and all Acts amendatory
thereto. I further certify that only kitchen, bath, oar drains are ected to the sanitary sewer. I further certify that the construction will not be
u~~d or occupied until a C of Occup cy has been issued b the Department of Community Services, Carmel, Indiana.
,.,' ,,~v
~..z-Ob
Oate
INSPECTIONS REQUIRED:
(Upper Footinv Lower Footing Under Slab
~ Meter Base ~ Site
**************************~***~*****~'***************
Filing Fees: "-1/7, :> 0
Base Inspections: It::. c::. .5'0 # Charged Re-
. -A Reviews
Cert, of Occupancy: S- 3 . 2:> v
~
Reviewedl ApproY : Dept. of Community Services
S:PermIts/FormS/ILP RES DENTIAL
P.R.I.F,:
~~~5J7.JcP
Fee ReceIved by:
Additional Fees