HomeMy WebLinkAbout06080102 Application
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City of Carmel/Clay Township Permit #: ()'oOSfQ;lO~
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: PHONE: FAX:
PA.-.\ E L1l0 'T \"-lL ?,I - B.!V' -'11 8 5ll ' 84C( . 'iLl,>
STREET ADDRESS: CITY: STATE: ZIP:
LP 5i CLA "'5-: i I-jI)iANA rev" 110- 4t>2. <=, 0
BUILDER'S EMAIL ADDRESS:
NAME:
J ~ EWLA.
BEST METHOD OF CONTACT:
'--L\... l! <=::>01- 4D(.,:~
L
PHONE:
'?i1 - 5'7 -oOT)
FAX:
STREET ADDRESS: .
c-
LOT #:
2D
k.l.110 E S'
CITY:
C,p,g
STATE:
I \.J ,
ZIP:
'0'''''
ZONING: is' ~ /
n'7
:5- _,
SQUARE
FOOTAGE: 84- 1 3.
ADDRESS OF CQNSTRUcnON:
\O:L
SECTION:
iC'610 c=D SIIC\o::' LAN\:::
SEWER UTILITY WATER UTILITY O(,dJ fJ" 1 00
PROVIDER: ClA"i' T",f' W~sr",\J, PROVIDER: CA~G,-l(!I-1E
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUN1Y WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE):
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY:
F CONSTRUcn
SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions, Remodels. Etc.)
FOUNDATION TYPE: (Check all that apply for the new
constr~cti?area )
1M' CRAWLSPA~ 0 POST & BEAM _~ER
o SLAB Iii' BASEMENT(WALKOUT:_Y~N')l
-~ r :~
,,< I ... --, ", '
For Single Family and Two Family dwellings/additions, remodels, and/or accessory structures, this permit is valilf,orily ~ con'struction commences .wi~l#n '
days of the date of issuance of the building permit, and must be completed (Certificate of Occupancy issued) wit~u1I8 months of the issuance date. dIas
structure permits are subject to the General Administrative Rules of the State of Indiana (See 675 lAC 12) regard~~g ~~piration time frames for be~ l
completing constrUction. '\ \ .::., \ \ Ink \1\
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alteration of a structure, or a?Y ch?-r,tge inM~@Se cl;f la'1.d 60stN.Jcture~
requested by this application will comply with, and conform to, all applicable laws of the State of Indiana, and the "Zoni~g'.o~dip.ance of Carmel Indiana - 1993" ,
289) and amendments, adopted under authority of J.e. 36-7 et se ,General Assembly of the State of Indiana, and all Acts ~!Een.si~tory thereto. }_fugher.cer . t only
kitchen, bath, and floor drains are connecte.cl to the sa. sewer. I rt certify that the construction will not be used or occupied until a Certificate of
OccuPfUlcyhas been issued by the Dep~tme~ Conununit Services, C el, Indiana. \
1---' , I\) / I. --
., }.-L" V -- ._.-._--~'-----
. n ture of Owner or Authorized Agen d nt
TYPE
TYPE OF IMPROVEMENT:
~ NEW STRUCTURE
o ROOM ADDITION(S)
o PORCH ADDmON(S)
o DECK ADDmON(S)
o REMODEL
_ Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION
PROJECT INFORMATION:
Early Release
Permit:
. Lot Split:
Manufactured
Trusses:
_yXLN
kY_N
_yj(N
_Y-)t:lN
Sump Pump:
ESTIMATED COST OF CONSTRUCTION: .
(EXCLUDING 'LAND VALUE) (, 10 0 C/O
)
.lQ4 G<>A) U' /)
~ ~~V.L,
~>... - ~
:r""MAP_~ARC~: () L.j () q 0 I d /70#
PLUMBING CONTRACTOR:
_f-\A M WI t S:n..J<;:
Plumber's Indiana State License #:
c..p {OOOO\ oi
Which plumbing codes will be applied to the construction:
~ntemational Residential Code w/lndiana Amendments
o Uniform Plumbing Code w/lndiana Amendments
-;:;[;/ N..
Da . ,
Reviewed/
FleE USE ONLY: ************~; *' * *********************************~*,._**********************
'It\ Filing Fees: _1'2. 0 If' ~ C'J
INSPECTIONS REQUIRED:,=,,:, -. ~..~ - -;:: ~;o" :"'~"" ~li'.lI":I1\J '--17.7 /"c
"" . m. ~ ..~;ll;"",..~.. ~~~OML,;T ON' .A_~..::> 1...2
__"",pper Footln!!, L wer Footing, Ul1tIlll\.5Iabj\/, !iw'eCJul I rios ""3 /'A
. - 6U ! :~~ ~eot'\Il).fi'u~~lJcl' 10 " \J _ .:l U
<-- ~-In J u.....r Base ~<;"ai D:~:~~t~~~~~~~~V'I~ES' : ~O
crC((:%:Q(\R~~EL I ClA-Y T : jJ Jl.l::ff.A~ . YO
Dept.ofCommunily\Services (Date)""'" li1\m,~N~ ~r6--
RESIDENTIAL
Fee Recejo:ed by:
# Charged Re'
ReViews
Additional Fees
Date