HomeMy WebLinkAbout06080086 Application
City of Carmel/Clay Township Permit #:CJIoO!? DpE? &,
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
for Single family, Town Home, & Two family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER
OF
RECORD:
NAME:
ecl
BUILDER'S EMAIL ADDRESS:
NAME OF UTILITY EXCAVATlDN CONTRAcrOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPUCABUE):
PROPERTY NAME:
OWNER:
STREET ADDRESS:
LOCATION
& PROJECT
INFO:
LOT#q(p
SEWER lJT1lITY A /J I I\ll
PROVIDER: Q; \~<..AV V
FLOOD ZONE AREA DESIGNATlON(S)
FOR THIS PROPERTY:
SINGLE FAMILY
TOWN HOME
TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions. Remodels. Etc.)
PROJECT INfORMATION:
Early Release )(
Permit: _V _N
Lot Split: _V kN
Ll()y) cl Of-
WATER UTIlITY f\ ^" I
PROVIDER: L.t\ V' I've.
iU1.shculed
TYPE Of IMPROVEMENT:
~EW STRUCTURE
o 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 DEMOLITION
Manufactured
Trusses:
Sump Pump:
~_N
.XV_N
PHONE:'6U l.p -Lf - {;()
m
B4 &-C(:;;~
~ w 4i.10
CITY: .
.:1)r\
. l~
BEST MrO~'9f CONTACt.,; - " -*'"'f'-'-"~-~"~
. 1_,:::0 r~" '~'\,- ~r'= -~-:-\ '
no. ,:.~((.ry~~., In"
FAX:
~ I
..
II
I I
pI.{
?
ZONING:
SQUARE 1 JD .
\' FOOTAGE: ,-,1
ESTIMATED COST OF CONSTRUCTION: 3 0 ;-.N"I
(EXCLUDING LAND VALUE) 2 .1.LN
l <; LA.
. lore'=J:I:- 06 OSoogC
TAX MAP PARCEL #:
PLUMBING CONTRACTOR:
fu.i \ G{. .
Plumber's Indiana State ~se #:
\ oc:::,c;ffi
Which plumbing codes will be applied to the construction:
o International Residential Code w IIndiana Amendments
~niform Plumbing Code w/Indiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area)
o CRAWLSPACE 0 POST & BEAM _PIER
o SlAB XBASEMENT (WALKOUT:_V N)
For Siogle Family and Two Family dwellings, additions, remodels, and/or accessory structures, this permit is valid only if construction commences wit~in 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 permits are subject to the General Administrative Rules of the State of Indiana (See 675 IAC 12) regarding expiration time frames for beginning and
completing construction.
I, the undersigned, agree that any construction, 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 Carmel Indiana - 1993" (Z~
289) and amendments, adopted under authority of LC. 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 Certilicate of
Deer aneyhas been i" by the Department of Conununity Se<Viee,. C~~~~'rcP <i/i 0 I ri::J
Print ~ Date
OFFICE USE ONLY: ** **** * * * * * * * **** ** * * * * * ** * * * * ~~ * * * * * ** * * ** * * * * * * * * * * * * :+:},* W,*;L 0 * ** * * * * * * * * ** * * *
INSPECTIONS REQUIRED: FIling Fees: . . a. 0
/"""F .. F t'~~ F t:--.... U d SI b Base Inspections: ;;2'7 7.. S # Charged Re-
"'--- ~er.. 00 I~wer 00 ~ n er a Reviews
- . ~. s~ Cert.ofOccupancy: _>-1,)()
CROUgh InRMete~Ball ~;=I iit<;...) P.R.I.F.: / 0. G~a Additional Fees
LA TOTAL: '0211,)- ()....O.
Reviewed/Approv: pt.ofCommunityServices (Date) e~ ~W. 8 Id...l/O~
S:Permits/FOITl1sfIL? RESIDENTIAL Receiv y; l /Date