HomeMy WebLinkAbout06080177 Application
City of Carmel/Clay Township Permit #: CJ~DY()/ n
I
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICA::rION
For Single Family, Town Home, &. Two Family: New Structures, Additions, Remodels, &. Accessory Str~ctures
FAX:
PHONE:
3/'1
NAML-
YAllt):>
BUILDER
OF
RECORD:
z~"1
R,/f)
{VI eA \)
ZIP:
<.(( (I 33
STREET ADDRESS:
IS-I ( Q()f..~S'i3. (2L>';<;#
BUILDER'S EMAIl ADDRESS:
1)
PHONE:
NAME:
PROPERTY
OWNER:
S;4r-Afi;
CITY:
STREET ADDRESS: '
,\,,' ,
< LOT #: <
';"'.,
SUBDIVISION NAME:
LOCATION
&. PROJECT
INFO:
ADDRESS OF CONSTRUCTION:
2. 2..-0 Z JJt> Av~
ESTIMATED COST OF CONSTRU
(EXCLUDING LAND VALUE)
WATER UTILITY (l
PROVIDER: vN-flt~
SEWER UTILITY 11
PROVIDER: C- ~i{'I\-- \.
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION I BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPUCABLE):
TAX MAP PARCEL #:
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY:
PLUMBING CONTRACTOR:
TYPE OF IMPROVEMENT:
TYPE OF CONSTRUCTION:
o SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
RESIDENTIAL (For
Additions. Remodels. Etc.)
o 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 DEMOLmON
Cl< p..'D~
Manufactured
Trusses: _Y )( N 0 CRAWLSPACE 0 POST & BEAM _PIER
Lot Split: SU!!lIl.PIUl\P'ION Y N 0 SLAB 0 BASEMENT (WALKOUT:_Y_N)
c: 1\C:r.: , ,.ONS I HUt.; 1 - -
For SinJd<<t ~ ~p.,~#rt~I:y:-4-~1~ilg~)1ci&ft\Idm-~~<6Q&iels, and/or accessory structures, this permit is valid only if construction conunences wi~hin 180
days ot'the aa~e ?~f~~~ BfKIj.9-b.9ij~g;J1e1imit. and must be completed (Certifi~ate of Occupancy issued) wi,thin 18 .mo~ths ,of the issuance da~e. ~ass I
structure pe~~ ~~uoJe,ct t9,tl}e ~e~ec-al,A~~&les of the State of Indiana (See 675 lAC 12) regaromg eXpiratIOn tune frames for begmnmg and
DEP f Ut- CO~,llVlL.'I'" I Y ~ -' completing construction.
I, the uAAersj~,.agre~(h-ll\.anY corys@f.9ot(rq:Q!iSltlNi&tihBrgement, relocation, or alteration of a structure, or any change in the use of land or structur;es
requestkilHy 'fhi~ppnt..itf6n wilJc~m~"lY :'fkth, and conform to, all applicable laws of the State of Indiana, and the ~Zoning Ordinance of Carmel Indiana - 1993"1 (Z~
289) and amendments, adopted bJddt .Qt.lt1iMtty of I.C 36-7 et seq, General Ass f 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. er certify that construction will not be used or occupied until a Certificate of
Occupanc been issued by the Department of Commu ervices, Carmel, Indiana.
Plumber's Indiana State License
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)
PROJECT INFORMATION:
Early Release
Permit:
tf'-1"6-CJ6
/W/Z..A-!>
Date
Print
*** *************************~***************
,. 9 Fees: I 3 3 , ./ (/
f I j, oU
I' .
oJ. :>0
::c*~r
OFFICE USE ONLY: ************
INSPECTIONS REQUI
# Charged Re-
Reviews
Base Inspections:
Upper Footing Lower Footing Under
~eter~ase ~ite
~ I
Reviewed/Approve Dept. of Community Services
S;PermltsjForms!ILP RESIDENTIAL
Cert, of Occupancy:
P,R,I.F.: , Addibonal Fees
~'1h t$;2f~dO
h"JtjJk q-~--cJV
Fee Receive : ( Date