HomeMy WebLinkAbout06090076 Application
City of Carmell Clay Township \Y' L. ~ Permit #: otto 1 h 1 It
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, & Two Family: New Structures, Additions, Remodels, & Accessory St~uctures
BUILDER of
RECORD:
NAME ~
tZ.o f!Ai!r I.- IN
PHONE
J'Lf~ - 5<0 ~ r
FAX
srll- '11 S ~
STREET ADDRESS
I i '2- 'L I3IVt
o~
CITY
~'-"rc-r<...
ZIP
tt6o'3~
STATE
IN
BUILDER'S EMAIl ADDRESS
I<-I( a..oe~/-./,..J
ADDRESS OF CQNSTRUmON ..." _ j
II 'l.. '2- gf~ R:>/?f4
PROPERTY
OWNER:
NAME
RIJ:tf
STREET ADDRESS
LOCATION
& PROJECT
INFO:
LOT #
10
SEWER UTILITY
PROVIDER:
NAME OF UTIUTY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA I BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE):
TYPE OF IMPROVEMENT: PLUMBING CONTRACTOR:
o NEW STRUCTURE ';t~ EbS ~ ~t:)'1 {.eK)Q(;;q-
iel ROOM A~f7N(S)t'( I~ Plumber's Indiana State Lice se #:
o PORCH A. ON(S) , I"~
o REMO~ 'tr! 3'/'
o mss~ ~LDING ~Which plumbing codes will be applied to the construction:
o HE~~E ~ International Residential Code w IIndiana Amendments
B ~~ ~a.~';.6...6.. 0 Uniform Plumbing Code wi Indiana Amendments
"'~ ~ ~ ~ -..>. ~ (Multi-Family Construction Code)
PROJECT INFORMATION: 'v. '" .-< ~ U ~
<.P. ~ t~;--\ OUNDATIONTYPE: (Checkallthatapplyforthenew
Early Release v-; Manufactured '-'k. '';- 0 '}...,%:j.~ :ct>nstruction area)
Permit: yY J;;N Trusses: ~~!&. ~ 0 CRAWLSPACE
Lot Split: Sump Pump: ~4~~ u '00 SLAB
Does any part of the property lie within a special Flo~ ~iIin~ _ Y v-r::
TYPE OF CONSTRUCTION:
Ittf SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units:
o MULTI-FAMILY
# of Units:
RESIDENTIAL (For
Additions, Remodeis, Etc.)
~
BEST METHOD OF CONTACT:
A-o'-- .~
PHONE
~
FAX
I&> eN 1.-111I
~
CITY
ZIP
STATE
NAME
o/ld PLJt-e.Z
,P'~
SECTION
oN-€.
ZONING:
qO
SQUARE
FOOTAGE:
WATER UTILITY
PROVIDER:
ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE) r() 000
o YOST & BEAM
CB" BASEMENT ./
WALKOUT: VY _N
--=:::=;-----:::----l
For Single Family and Two Family dwellings, additions, remodels, /dU,cces ttiturcs. this pe~jUs..valid~lY1t~gn~~c'~~~~~~Ji"e~,~es
within 180 days of the date of issuance of the building permit, and ;t -fji,..,Eom ertificate of Qccu aJi6Y ~u.<:d):vntbJnj8.montli~ bfth~
issuance date. Class I structure permits are subject to the General Ad:nt~. ~ve R es 0 the State of I~~tt~. 0" E<<inTAC12) regarding ~~Nrlllon
time frames for beginning dQnpleting construction. \ \ \) \ ' )' \ \
I, the undersigned, agree that any construction, reconstruction, enlargement, r ocarinn, or alteration of a struq~UI_, any 'e . ~{,9{)land\ l \
structures requested by this application will comply \vith, and conform to, all applicable laws of the State of Inqtfl.~~l d thS~ni~ ~clinanee of d~1 \
Indiana -1993n (Z-289) and amendments, adopted under authorit' C. 36-7 et seq, General Assembly of the Stf 1;W Indiana, and all Acts am~ciiy \
thereto. I further certify that on.Iy kitchen, bath, and floor ns are conn ted to the sanitary sewer. I further ti~ ~en~ will not- be \
used or oceu ied until a Certifieat [. ccupaneyh een issued hy th De=; co~;e:~e s, car::::::-..,..t7~-----'
Date 1
******~~ttt** *********************************************
- /- iling Fees: ~/ c., 3 II
PECTIONS REQUIRED: / /' ;
Base Inspections: r: c. J () # Charged Re-
Under Slab /' ReViews
Cert, of Occupancy: ::) J , S;-d
Reviewed/Approved: Dept. of Communi
S:J>ermits/FormsfILP RESIDENTIAL
ite
(Date)
eived by: