HomeMy WebLinkAbout06080190 Application
City of Carmel/Clay Township Permit #: 0 le o'6'O!~()
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER of
RECORD:
FAX
//-~"I3osry .)1)_
STREET ADDRESS
CITY
STATE
ZIP
c::. R A-
3'
BUILDER'S EMAIL ADDRESS
BEST METHOD OF CONTACT:
C&~ 3-0101
PROPERTY
OWNER:
PHONE
,
1"<(
FAX
57~ .!JEJ5/
STREET ADDRESS
CITY
STATE
.:r/V.
ZIP
'V6:?35
ZONING: S - 3
~gg~~~E: 5 ~ 31
SUBDIVISION NAME
==
LOCATION
&. PROJECT
INFO:
,/1/. C ~4'c
- C.r/l.
SEWER UTILITY
PROVIOER: c:.;<:lA:J rt2
NAME OF LfTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION I BZA f BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'5 (IF APPLICABLE):
TYPE OF CONSTRUCTION:
ClY'SiNGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units:
o MULTI-FAMILY
# of Units:
o RESIDENTIAL (For
Additions, Remodels, Etc.)
TYPE OF IMPROVEMENT: PLUMBING CONTRACTOR:
~W STRUCTURE c,.1:Ii!J;:j;~ C~)t..:CL
o ROOM ADDITION(S) Plumber's Indiana State License #:
o PORCH ArJrt!l9FP Pc::: / (] 5 Oe:J 3 2 (
o REMODEiSLlhi ~~ED
o ACCESSORY"BBtPl.~: f:C,;"Ch plumbing codes will be applied to the construction:
o DET~cg~, Orn!Jli~r ~N~"Aal Residential Code wI Indiana Amend~ents
o ATT 'li 'i1/e Co wi," IHUt' '
o Co "f)lQclln1fOt6l'~t^,mbl;r<<911~e wI Indiana Amendments I
DEM 'f: CAR Iv;I'v!U^iMIA~i~(Jcti~n Code)
PROJECT INFORMATION: '" Iv;I2 ~v;"V!i:';(, os. . f)S
Early Release / Manufactured JN~ ~q~E: (Check all that apply for the new
Permit: _Y LN Trusses: _Y ~ I,<ffl?~' ~W^I S
. ~ cRAwLsptilli-llP 0 POST & BEAM
Lot Split: _ Y ~ Sump Pump: ~ _N 0 SLAB ~ BASEMENT
Does any part of the property lie within a special Flood designation area: _ Y _N WALKOUT:_ Y
N
For Single Family and Two Family dwellings. additions, remodels, and/or accessory structures, this permit is valid only if construction commence~_,.__.
within 180 days of the date of issuance of the building permit, and must be completed (Certificate of Occupancyjssu~d}~thin,:~~;pt~n~~-rcif the ;'-.::'" 1
issuance date. Class I structure permits are sub~ect to the General, Ad.ministrative Ru~es of the Stat~ of Indiana ~,~~~7~~C,!~~,~r~g~~~pg-~jy~~atiOri. \ ,\ \
. . tlme fram~s for begInmng and co~pletmg construction. ~ \ \ \ \ 1..;:= -:~------_..~- \ \ \ ,\\
I, the underSIgned, agree that any construction, reconstructIOn, enlargement, relocatiOn, or alteration of a structure, OJ! an~1~e In the use of lan,d,o,r \'\1, 'I \
structures requested by this application v",ill comply with, and conform to, all applicable laws of the State of Indiana, a9~!\.~ jZoning Ordinance o,{ ~~m.el 1\\ I
Indiana -1993" (2- 289) and amendments, adopted under authority of I.C 36-7 et seq, General Assembly of the State of ~~li~n , andA\9(Y:t~nG-nditory \ \ \ I
thereto. I further certH hat only kitchen, bath, and floor drains are connected to the samtary sewer. I further certify f~t\t e construction will not be I L:
use ,u . e ' a Certi . ate ccupancyhas been issued by the Department of Community Services, Cali~l,\. I diana.:._------1
''0(./(;. L145 A . C<>77"",L g- 3o~"'&
Print '- -Dile
OFFICE USE ONLY: *********** ********7* *** *****************~'*************************
C 9; Fi ng Fees: L!. 7 /0 I
NSPECTIONS RE UIR:- r u 'I 7 .......-11 '
_ ". ., ase Inspections: "" '? . .) V # Ch~rged Re-
Under Slabd . ~ -:>, ...-- A Rl:vrews
Cert. of Occupancy: '-" ./ _ 2-!'
P.R.I.F.: d-& 0 Additional Fees
----
Reviewe IApproved: Dept. of Community Services (Date)
S:Permits/Forms/ILP RESIDENTIAL