HomeMy WebLinkAbout06080167 Application
City of Carmel/Clay Township Permit#: /)(J0<60 !t.o1
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
I
\.
BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
&. PROJECT
INFO:
SEWER UTIlITY
PROVIDER: C
NAME:
STREET ADDRESS:
BUILDER'S EMAIL ADDRESS:
NAME:.:
b
STREET 'ADDRESS:
so
LOT#:
3
ES
E ~OD
SUBDIVISION NAME:
L
ADDRESS OF CONSTRUCTION:
PHONE:
(3'
CITY:
T
ZIP:
BEST METHOD OF CONTACT:
PHONE:
FAX:
(31
CITY:
INt.'ANA
STATE:
IAl
ZIP:
SECTION:
ZONING:
s
5-
SQUARE
FOOTAGE:
15
TYPE OF CONSTRUCTION:
o SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
/ time:
~ RESIDENTIAL (For
Additions, Remodels. Etc.)
1i
PROJECT INFORMATION:
_y L~
_Y1N
S:Permits/FormS/ILP RESIDENTIAL
TYPE OF IMPROVEMENT:
o NEW STRUCTURE
o ROOM ADDITION(S)
o PORCH ADDmON(S)
o /,DECK ADDmON(S)
fJl' RE~DEL
....::L.. Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION
Manufactured
Trusses:
Sump Pump:
&_N
~Y_N
ESTIMATED COST OF CONsrf-UCTION:
(EXCLUDING LAND VALUE) if 31 0.00
NAME DF UTI EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTI WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE): Jb
FLOOD ZONE AREA DESIGNATION(S) TAX MAP PARCEL #:
FOR THIS PROPERTY:
Early Release
Permit:
Lot Split:
PLUMBING CONTRACTOR:
PAu.l E. SM;TH ~CC---- :.-::~-:--;-'; ( ',\ \
Plumber's Indiana State License.#~\tc' "-~:' :~.::.~___,_._'L I. \~.
101'177 \II \ I fC'c:-- I ), II
lI'....-' \ ,\ \
ZiC lumbing codes will be opplie~ ~ the c~l"f\Ictjpn~ 2806 i'; )11 \
\1, \\ \ tr 0 t , L I
International Residential Co~e\Y":/In lana Amend~ents ~ l--" I
I!, .\i____..."-'-'-'- I
o Uniform Plumbing Code wllndiana.Amendments _"_".~
I.-
FOUNDATION TYPE: (Check oil that apply for the new
construction area) ~-
o CRAWLSPA9' 0 POST & BEAM _~R
o SLAB r!f BASEMENT (WALKOLrr:_y..LN )
For Single Family and Two Family dweIling~~ifiQtyI.Jr;c;~f~or accessory structures, this permit is valid only if construction commences within 180
days of the dat~~~~,~~l3rl~b ~bMPIeted (Certificate of Occupancy issued) 'Within 18 months of the issuance date. Class I
structure permi~Ttmfl.'t'totlift,~ffl::.e,~s~tragWlii\Qt'iJie State of Indiana (See 675 lAC 12) regarding expiration time frames for beginning and
Subject 0 CO_ ,1 Codes. completing construction.
I, the undersigned, agree thaofn~a\ariOOJ;.R-~8ilstructl~H-~@t, relocation, or alteration of a structure, or any change in the use of land or structures
requested by this aPR~~ MU:cmlWUy.{NJ~~rS tQ,hilYa~e laws of the State of Indiana, and the ~Zoning Ordinance of Cannel Indiana -1993" (2-
289) and amendme~tlopte'd' ~nl er a'p~J ,icy p~.q:.. ~~-qt:~i\~m.bly of the State of Indi~na, a~d all Acts amendatory t~ereto. ! further :~rtify that only
kitchen, bach, anm~t@faGJMta.M ,~l:h~!trlIMy ~e~et." i hi;'"th;~ 'cerufy that the constructIOn will not be used or occupIed until a Certihca.te of
Occupancy has been issued by the DePtNm-At'QAmmunity Services, Carmel, Indiana.
. Q.B' LOR.', A.~;RbSONr,-HEN';NE.
Print
,-/7 I()/"
Date
OFFICE USE ONLY: ************************************** **********************...!.-********************
INSPECTIONS REQUIRED: ~ _ Filing Fees: /43, 6 0 :
tlll\ Base Inspections: II / , 00 # Charged Re-
__ Re~ews
Cert, of Occupancy: 53 ,,-5 0 '
Upper Footing Lower Footing Under Slab
C R;~ Meter Base C!ina'S Site
P.R.I.F.:
Additional Fees