HomeMy WebLinkAbout06080078 Application
City afCarmel/Clay Township Permit #: {Xa03bOn
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
&. PROJECT
INFO:
NAME~116IA.r.....
STREET ADDRESS:
I.{O'r i/,. (fO
,......05
6v'1Sf-
BUILDER'S EMAIl ADDRESS:
()~
t; /6u..-n
STREET ADDRESS: .
OJ 1/, ~ 1-"" j),.
33<; -2<::rze>
FAX:
(317) S7I-Ii'lZ-
SUBDIVISION NAME:
colt.. c. He' klr
,
'/ sit?
OTY:
JI->. Ie
STATE:
.:::z::
ZIP:
~.G 2~
BEST METHOD OF CONTACT:'--~
( f> ~~5-Zo2Cl
,
FAX:
(srl) ~/- II~/ 2-
PHONE: -___
\ 'Z,ll/lfW-o'OS -
C :
~+
STATE:
~
ZIP:
'7629'0
--2
15'7 d
~SEcnON:
lit ""c.
ZONING:
SQUARE
FOOTAGE:
ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING ~D VALUE) ,,.CS:::Y?<::ta:za;;::--(5;,o
'j r-''::':'':''~'r(~~ (C':';; \ ~,. " '\!I G~; '\.\ \ \
,l\ '\'-'-.1 ,,-~-::::.' ,_. ~~.__:_._._..~----\ j \ \ :',
\Ii \" r:~:----~-"."--"--' '11\ \ \\
TAXMAP!ff~~( A' 11442~gQ5 \\\))\
"I' "\'-'-" \
PLUMBING CONT~Q:~R: __ _----"'- ,~
Plumber's Indiana ~cense'#U -
SEWER lJTILITY WATER UTl~
PROVIDER: c..'7 tJl. W PROVIDER: p, I/.~ I1/cll
NAME OF UTILITY EXCAVATION COI'ITRACTOR; PLAN COMMISSION I BZA I BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNn WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE):
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY:
TYPE Ql'CONSTRUCTION:
IB"'SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
/time:
rJ?f RESIDENTIAL (For
Additions; Remodels. Etc.)
PROJECT INFORMATION:
Early Release
Permit:
Lot Split:
_Y~..
_Y --Ld'I/.
TYPE OF IMPROVEMENT:
o ->'fW STRUCTURE
IIa" ROOM ADDITION(S)
o PORCH ADDmON(S)
o DECK ADDITION(S)
o REMODEL
_ Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLmON
Manufactured
Trusses:
Sump Pump:
Y~
Y~/
Which plumbing codes will be applied to the construction:
I
o International Residential Code wI Indiana Amendments
o Uniform Plumbing Code wI Indiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
constructI,area) I
0' CRAWLSPACE 0 POST & BEAM ~PIER
o SLAB 0 BASEMENT (WALKOUT:_Y_N )
For Single Family and Two Family dwellings, additions, remodels. and/or accessory structures, this permit is valid only if constrUction commences within 180
days of the date of issuan.ce of the bUiRmdin . lit be completed (Certificate of Occupancy issued) within 18 months of the issuance date. Class I
structure C'DRmI' . s . Rules of the State of Indiana (See 675 lAC 12) regarding expiration time frames for beginning and
completing construction.
I, the unde e' c ti, reconstruction, enlargement, relocation, or alteration of a structure, 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 Cannel Indiana -1993" (Z~
289) and amendments, adopted under authority of I.C 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 used or occupied until a Certificate of
OCC:~;;R~Ofcommu~~,~ana:r/ p/t-~ 5-- '-' I?~~t?t
Signature of Owner or Authorized Agent Print Date
OFFICE USE ONLY: ******************************~~****** .**************7<-*:1,*Jtj'*****************
INSPECTIONS REQUIRED: Filing Fees. / -
. . Base Inspections: ./ b 6. ;;:J
Upper Footln Lower Footing Under Slab ' :,..-)
Cert. of Occupancy: 5J. :)U
\
~\
,I
Reviewed/App oved: Dept. of Community Services (Oate)
S:Permits/Forms/ILP RESIDENTIAL
Meter Base
~Site
P,R.I.F,:
# Charged Re-
ReViews
Additional Fees