HomeMy WebLinkAbout06080079 Application
City of Carmell Clay Township Permit #: 0 ~ 0 r (j)"iJ
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER NAME: PHONE: FAX:
OF (!J..IF/~ /Uf1.-{ I<r' (! 0(), P. 1'7-370- !f8'f 3 .:? 17 -.A r 3,- g $iS'
RECORD: STREET ADDRESS: ct CITY: STATE: ZIP:
'z- (?, s-r ~ f'L_ ~,0!>.'''W4 "J.Kf
~ eli-UtA ErL--
PROPERTY
OWNER:
BUILDER'S EMAIl ADDRESS:
ei- f'-P w o,::r- G 40L, CDM."
NAME:
~#L/ b.h<rJSo tJ flll,> hn'
STREET ADDRESS:
109 I ~
LOCATION
&. PROJECT
INFO:
LOT #:
1LJ+l.~W iC'/C Uk,
SUBDIVISION NAME:
SEWER UTILffi
PROVIDER:
~
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPUCABLE):
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY:
TYPE OF CONSTRUCTION:
o SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
/ time:
&" RESIDENTIAL (For
Additions. Remodels. Etc.)
TYPE OF IMPROVEMENT:
o NEW STRUCTURE
o ROOM ADDITION(S)
o PORCH ADDITION(S)
o jlECK ADDITION(S)
WREMODEL I<ITCKC/
_ Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION
PROJECT INFORMATIO!'f: /'
Early Release <../' Manufactured
Permit: Y _N ~Trus5es:
Lot Split: _Y ~ Sump Pump:
yv(
Y~
BEST METHOD OF CONTACT:
c:.~-'?rl~,< /C'eiL
PHONE: 'J, '7- !fy::r -0" '7 '7 FAX:
a C/I-r :,()cv ~~.
CITY:
(! "'NEt..
"1)0 -8
STATE:
"JJ1f
ZIP:
'-/{",o3)
zr--~......
va
{SQUAi<. ., -~
EOOTAGE:--->_l,r~2d'
SECTION:
ESTIMATED COST OF CONSTRUCTION: '.J\..-
(EXCLUDI~~;~R'yALUEL 4' $Or-~L0__
11[1) lC" ct..; Ie"~ iJ \'/1 iC~; I'::":
Ii I J r-~....-:.;~--:,,_.~-::-~2...:_--:~~ll j \ \j
,J. ) , , I L
TAXitr"lrtRcELtUG 1 4 2006 III !II
,II III 1l!.::J
PLUMBING qONTRACTOR: -------J
, C:.. Cu h 1t1CC-'lI'1-""r'4 L
Plumber's Indiana -State Llcense~
PC ~lbr7yo(.
Which plumbing codes will be applied to the construction:
o International Residential Code w/Indiana Amendments
o Uniform Plumbing Code wI Indiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area)
o CRAWLSPACE 0 POST & BEAM PIER
o SLAB ~SEMENT (WALKOUT:_Y )( N)
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this permit is valid only if construction conunences witirun ISO
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 pemu. 'ts are subject to the Gene<a1 Adminii.;:"..Ie~., o1r;I;:i~; ~~~~:~~o~.ee 675 lAC 12) regarding expiration time frames for beginning and
I, the undersigned, ag.ree that an c sm. ~. .' .c~ifflX~~~, relocation, or alteratio~ of a structure, or ~ny cha~ge in the use of land. or structu:es
requested by thIS apphc . t -4.~~~fo o\4tlhll5'phcable laws of the State of Indiana, and the "Zonmg Ordmance of Cannel Indiana ~ 1993 (Z'
289) and amendments, a p oriry- Of I:t. "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 ar onnected to the sanitary sewer. I further certify that the construction will not be used or occupied until a Certificate of
Occupancy has been issued by the Department of Community Services, Cannel, Indiana.
. JItM 1&-- C!l,F/08R.D /d'/I(f;;.,-r- g//:1)Ot,
Signa ner or Authorized Ag Print Date
OFFICE USE ONLY: ***************************************************7* ~~****~*******************
F'j' F . -::; 3- J 0
INSPECTIONS REQUIRED: I Ing ees. .
. , Base Inspections: / / /. (j 0
Upper Footmg Lower Footmg Under Slab , 0
8 --~ Cert. of Occupancy: )'"3 - ')
Rough In Mete. r Base rFfr1aI~ite
~ P,R.I.F.:
C_"d-~~ Hl~ ;?-/t;-O-b r/ A~T~.L~j .f ~~/;3/~
Reviewed/Appro d: Dept.ofCommumlyServlces (Date) ~~" _~
S;Permits/formS/ILP RESIDENTIAL Fee Receive : ' / Date
# Charged Re-
ReVIews
Additional Fees