HomeMy WebLinkAbout06080170 Application
City of Carmel/Clay Township Permit #: rJ&lJ3P/70
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
ADDRESS OF CONSTRUCTION: /.
WATER lITIlITY
PROVIDER:
BUILDER
OF
RECORD:
NAME:
STREET
PROPERTY
OWNER:
NAME:
STREET ADDRESS:
LOCATION
& PROJECT
INFO:
LOT#:
SEWER UTIliTY
PROVIDER:
~\fu\1
SUBDMSION NAME:
00 'f1!lcr{ljJy()
FAX:
STATE:
ZIP:
SECTIO:.3
ZONING:
rcc---::,~---,-~g~~;~~;-Ya&l}
l''-''''''-''''''''\'I\'--''~'\''
ESTIMATE CO~9F,<;::ONstRurnON: ~\I ~.J Or~ ,I ,;:
(EXCLUDING lAf:l~lvtLUE)--- -... - - I 1 I
1,. ,II II . ,I'
Al 4\[;\'AoJ<>>'I.fiI'?'l 9~~o/~JIII
~lLQ-P 111 II
'II '}I IL-l I
TAX MAP PARCEl: t: . ~~
1'Or ~9r:r~1 '_
~i /hi Y_~J6. PIli"
'll'Sa : 44~
~.
NAME OF VTlUTY EXCAVATION CONTRAcrOR; PlAN COMMISSION I BZA I BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'5 (IF APPUCABLE):
FLOOD ZONE AREA DESIGNATlON(S)
FOR THIS PROPERTY;
TYPE OF CONSTRUcnON:
.MINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions, Remodels. Etc.)
PROJECT INFORMATION:
yX;:
YAN
Early Release
Permit:
Lot Split:
TYPE OF IMPROVEMENT:
,XNEW 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
Manufactured
Trusses:
Sump Pump:
~Y_N
-t-Y_N
Plumber's IndIana St1Jt"C)'cense #:
1 []I=)q ()
Which plumbing codes will be applied to the construction:
o International Residential Code wI Indiana Amendments
)S('Uniform Plumbing Code w/Indiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area)
o CRAWLSPACE 0 POST & BEAM PIER
o SLAB )(:BASEMENT (WAlKOUT:_Y XN )
For Single Family an~~~cG . , , accessory structures, this pennit is valid only if construction commences within 180
days of the date of i~F"O('m~U4~~~ r;pUstiltll;;i,\~ (Certificate of Occupancy issued) within 18 months of the issuance date. Class I
structure pennits arSUlij~tthttrth~alA8re~Mae't5~s of the State of Indiana (See 675 lAC 12) regarding expiration time frames for beginning and
oi State an ~\c;qP'R!!:t!igconstruction.
I, the undersigned, aglf'\pR\iS1Jfl~S~m"'~~OISi~~h?lOCation, or alteration of a structure, or any change in the use of land or structures
requested by this appliM~ w\ll~mp.IY.Wit dc, tPofthe State of Indiana, and the ~Zoning Ordinance of Cannel Indiana -1993~ (Z'
289) and amendmenQ15bfe(!)fid~ 11c~~~el~~mblY of the State of Indiana, and all Acts amendatory thereto. I further certify that only
kitchen, bath, and floor arains a connected lNel~NA sewer. I further certify that the construction will not be used or occupied until a Certificate of
occupan, h", been i>>ued h e D ent 0 Community Servie,", Cannel, rndiana.().. YI CJ/ ;;Jt/ rp
Slgnatu of w er Authorized Agent Print Date
OFFICE USE ONLY: **************************** * **.~******.****** * ******827*$/0***** * ************** *
INSPECTIONS REQUIRED: FIling Fees, -'-
--:-~, Base Inspections: c/77 :)'0
pper FootIng" ower Footing Under Slab
el ~
') 3 s-o
)0< {. / ~ Additional Fees
~ TOTAL, ~{/ 53 Yb
,. ,..!;UtA 17 /' //(44{-
'1 '1 tJ(p
# Charged Re-
ReViews
P,R,LF,:
Celt, of Occupancy:
- -0
Reviewed/Approv : Dept. of Community Services (Date)
S:Permits/FormsjILP RESIDENTIAL