HomeMy WebLinkAbout06080042 Application
~CitY of Carmel/Clay TO~ShiP Permit #: 0(00<7,~
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
.JILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
& PROJECT
INFO:
SEWER UTILITY
PROVIDER:
NAME:, fYlCll:>12.. 6
R6SIOIl.1\nClt..J
STREET ADDRESS:
"31010 '5l-t€LG'( <;;T.
BUILDER'S EMAI~ADDRESS: \
bK("\~ ~ ......c.vr.ct.C.fIs+a.r4t.rQ....' (o~
PHONE:("1il) Il,-'3~(,2 FAX: (,n 7'1(-1'i'1{)
CITY: STATE:
-:C'" I) f7L~ :r-,v
BEST METHOD OF CONTACT:
C:!>II) :"'3'1- ~0/8
ZIP:
402-7
- odl...l<tr
NAME:
Thel<llS I ~--r~1I6
PHONE:
l'3,') '5("'l-()b4~
FAX:
STREET ADDRESS:
\'-tllo I,N8.FClIll>
LOT #:
WA'f
SUBDIVISION NAME:
ADDRESS OF CONSTRUCTION:
\'-11 It) \N ('LF<>(l!\
CITY:
QA1l.Mtl
STATE:
~
ZIP:
4&6"') 2.
I\~
WATER UTIlITY
PROVIDER:
SECflON:
ZONING:
eM WI n --r,J t.f1.6J'1.
SQUARE
FOOTAGE: ''dS"O.. r-
ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING LANO VALUE) /7 '897. 9/
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION I BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNlY WELL AND/OR SEPTIC PERMIT #'S (IF APPUCABUE):
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY:
TYPE OF CONSTRUCTION:
~ SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
consb'Ucted at this
time:
'rfi. RESIDENTIAL (For
Additions; Remodels. Etc.)
PROJECT INFORMATION:
Early Release
Permit:
Lot Split:
_Y~N
_Y~N
TYPE OF IMPROVEMENT:
o NEW STRUCTURE
o ROOM ADDITION(S)
o PORC ADDmON(S)
o 0 ADDmON(S)
REMODEL
_ Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOUTION
Manufactured
Trusses: Ly _N
Sump Pump: _Y JLN
TAX MAP PARCEL #:
PLUMBING CONTRACTOR:
It
.
Plumber's Indiana State License #:
Which plumbing codes will be applied to the construction:
o International Residential Code w IIndiana Amendments
o Uniform Plumbing Code w/Indiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area)
o CRAWLSPACE CVPOST & BEAM PIER
o SLAB ~ENT (WALKOUT:_Y - N)
u
For Single F~ ~ "(wo t..3!!!iJy, .awe n s., ',' and/or accessory structures, this permit is valid only if construction conunences within ISO
days of the 'aa1!'Ht'r~Il2tg~f kIH~~fiUdmg'~, fa@lihilbibtlslmpleted(CertificateofOccupancyissued) within 18 months of the issuance date. Class I
structure permits are 9U.b~Q~~~tive Rules of the State of Indiana (See 675 lAC 12) regarding expiration time frames for beginning and
~E T O~ cnM~~IIr-.IITV "<=DII r'<=Ccompletingconstruction,
I, the unde' ,~ree that anTc'or'1Sft~t'idr\, Tet:ohS~ctM~~ement, relocation, or alteration of a structure, or any change in the use of land or structures
requested s ppll.6tGMM;;1 Ctbl ~op~N'SfR,tiJab!e laws of the State of Indiana, and the "Zoning Ordinance of Cannel Indiana -1993" (Z'
289) and amendments, adopted un ~iJ~o(i.c. 3((,let seq, t;en~ral Assembly of the State of Indiana, and all Acts amendatory thereto. I fUMer certify that only
kitchen, bath, and floor drains arelNlnte sanitary sewer. I further certify that the construction will not be used or occupied until a Cerci/icate of
occuP~;J.n iss ed by the Department of Conununity services~l, IndiXR IIV ~ g' /1/ 0 I:,
Signature of OWner or Auth' Agent Print Date
OFFICEUSEONLY:******************************************************~*****~*****************
F'I' F I ':; 3 .>
INSPECTIONS REQUIRED: ling ees: .
Base Inspections: / I! 00
Cert. of Occupancy: . .s- 3. s1J
Upper Footing
Lower Footing
Under Slab
QOU9h 0 Meter Base C Fin;I-~ Site
# Charged Re-
Reviews
€/V-'
Dept. of Community Services
S:PermIts/Forms{ILP RESIDENTIAL
-Cf -06
(Date)
'T;c&~ 06-"~'-
Fee Rece ved by: Date