HomeMy WebLinkAbout06090043 Application
City of Carmel/Clay Township Permit #: tJ(p(ff {J1JL/3
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, l!r. Two Family: New Structures, Additions, Remodels, l!r. Accessory Structures
BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
l!r. PROJECT
INFO:
NAME:
1<.'3 HC'>/Yc5
STREET ADDRESS:
'i740
BUILDER'S EMAIL ADDRESS:
NAME:
SA....!:'
STREET ADDRESS:
LOT #:
Its
:;-
PHONE:
3/'} €,21
FAX:
<' .
'I"
I PHONE:
I //1
SED FQ~C0J1S1~dcTIOtfATE:
SUBDIVISION NAME: U I f ~"""".n.k;';.a>- 'Ide' ECTION:
~ iO-5S 0 ~/'"Yr::rr:-~ '
"
ADDRESS OF CONSTRUCTION: ~rrv t:ll= r.ACMEL / C ':( TOWNSHlfI.
/ / Iff., f1 E /fl'I">' . r.r Il. i) 'I! ,
SEWER UTILITY WATER UTILITY O&Oq O1JLj I
PROVIDER: C I./ty T~WA)51J IP PROVIDER: C~ H ~ I-
8'1 DD
0lY:
:r f() D AJ PL5
STATE:
X'D
ZIP:
'1(,2'11
BEST METHOD OF CONTACT:
'3.1.'1 !fl.l 1(/06
OR t71JtJ/J bY.
FAX:
ZIP:
\
ZOJ9INGj>. R /
SQUARE
FOOTAGE:
4NI 'f
ATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE)
2.'I~b'lO
NAME.Of_UTILITY.EXCAVATlON.CONTRACTOR; PLAN COMMISSIDN / BZA / BPW DOCKET PrV IIV DC' )<' r e" IJ..
NUMBERS; TAC DATE(S); AND/OR COUNlY WELL AND/OR SEPTIC PERMIT #'5 (IF APPUCABLE):
Ft:6QDjZONE',~Rg,!'-DESIGNATlONlS)
FOR THIS PROPERTY:
TYPE OF CONSTRU ON:
SINGLE FAMILY
'0 TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions, Remodels. Etc.)
Early Release
Permit:
PROJECT INFORMATION:
-y-&
_Y1N
Lot Split:
;z.C:OAJE )< tUNS IlI>Ef>
TYPE OF IMPROVEMENT:
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 DEMOLITION
~. ~
Manufactured
Trusses:
Sump Pump:
C'UXiMAJ?;PARCEL.#"
PLUMBING CONTRACTOR:
S-fl61'J.'.fD,f<--- ~:-fe~e tn'Dtler-
Plumber's Indiana State License :
l?r?J1tJ 2. V 3
Wh~ plumbing codes will be applied to the construction:
szr International Residential Code w/Indiana Amendments
o Uniform Plumbing Code w/Indiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area)
o CRAWLSPA9!' 0 POST & BEAM PIER
o SLAB c:'i' BASEMENT (WALKOUT:_ Y_i-1't)
For Single Family and Two Family dwellj.ngs, add~1jonJ;!enf9dels;~?r',~~j:~'sSory ?~ructures, this pennie is valid only if construction conunences withm 180
days of the date of issuance of the build~ngp~~ti.'aii4}~u?t:~~ ~orriplece_c!_(~Jr;tifii:.~te of Occupancy issued) within 18 months of the issuance date. Class I
structure pennits are subject to the Gener~ ~dmiiiist.?ativeRules'of tneState?~ ln4i~a (See 675 lAC 12) regarding expiration time frames for beginni,ng and
\ \ \ .}) \ completing construCtion.
I, the undersi~ed, agree :hat a.ny construc~\9n;-recfnstruction, enlar~e.men~~locadA.n, ~~\~lteratio~ of a structure, or ~y cha~ge in the use of land, or structu:es
requested by thiS application will comply WI~~,fa'I1~ confoJ:l1P:~ alhp~lC~eJ~ws of ~he ,Sp~te of IndIana, and the "Zomng Ordmance of Carmel IndIana - 1993 (Z-
289) and amendments, adopted under authorttY. of I.t. 36~'r'h seq, General Assembly',6f the State of Indiana, and all Acts amendatory thereto. I further certify that only
kitchen, bath, and floor drains are connected to th~ ~anitary sewer. I further certify-Hi;rtth~ construction will not be used or occupied until a Certificate of
IW '." . ___~ ,
Occupancy has been ;" by the D~~artment of Commnnlt)'Semces, Carmel, Ind;""'j /
h-!' '/ - r- 'J"o'tr---fF: G, ( jJ L E Y .11-') EpJ{ 9: 7 /1':> (,
"gn ture of OWner or Authorized Agent Print DatlE!l' ,
OFFICE USE ONLY: *********************************************************************************
NSPECTIO~QUIRED: ~ 0 Filing Fees: I q -r ~ '10
Upper F . ~er FO~ Under Slab q\f\ Base Inspections: "^ ~ 7 ,50
\ \ Cert. of Occupancy: ~ :3. 50
Me er Base f.'nal I Are I, 0 0
;"3 Z 9'. 10
S:Permits/FormS/ILP RESIDENTIAL
# Charged Re-
Reviews
Additional Fees
(Date)
Fee Received by:
Date