HomeMy WebLinkAbout06090090 Application
\r;itY of Carmel/Clay Township Permit #: lJVZA (}t) 90
\
ESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Stru'ctures
I
y
NAME:
b
....LDER
.IF
RECORD:
PROPERTY
OWNER:
LOCATION
& PROJECT
INFO:
lACE
SUBDIVISION NAME:
L
ADDRESS OF CONSTRUcrrON:
FAX:
(3/7)3"17-73 ~
STATE:
:f
ZIP:
l{, ~ ~
"FAx::'~(:.:; ,
s
.... '-',
ZIP::' ,
'33
'1/
~S /,? //
. 'I / '/
1/ 1/,
SQUARE,';',',:>;!/
E ',F~TAGE: S~:
ESTIMATED COST OF coN518urnON: ", /
(EXCLUDING LAND VALUE) II ;/0 . ~
NAME OF UTIllTY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA I BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE): :fb
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY:
Whi~lumbing codes will be applied to the construction: ~
[i('Intemational Residential Code wI Indiana Amend~ents
I
o Uniform Plumbing Code wI Indiana Amendments I
FOUNDATION TYPE: (Check all that apply for thelnew
construction area)
9' 0' ~CRAWLSPAg;. 0 POST & _ BEAM -'-';JfR
:t q;J; ~SLAB ~ BASEMENT (WALKOUT:_y-LN )
I " f:li11
For Single Family and Two Family dwellings, additions, remodels, and/or accessory ~@I 'il~t IS valid only if construction commences Wlclun ISO
days of the date of Issuance of the buIldmg penrut, and must be completed (CertifGe1Jft'~Itlt~ Issued) Wlthm IS months of the issuance date ~Iass I
structure penruts are subject to the General Administrative Rules of the State of In~~e~~IJ(Q: 12) regardmg expiration tune frames for begmnmg and
completmg cons Ii@; 6) I "'1l. I
I, the undersigned, agree that any construction, reconstructIOn, enlargement, relocall~~ l.a.eucture, or any change m the use of land or structu~s
requested by thIS application WIll comply wlth, and conform to, all applicable laws of ~Iu.lana, aEli the "Zonmg Ordmance of Carmel Indiana - 1993"1 (Z~
289) and amendments, adopted under authonty of I C 36-7 et seq, General Assembly he..S.t~l(m*nond all Acts amendatory thereto I further certIfy that only
kitchen, bath, and floor drams are connected to the samtary sewer I further certify t ~ ~s~~r(5)ill not be used or occupied until a Certificate o~
o upancyhas been Issued by the Department of Community SelVlces, Carmel, I ~ J~ !P.. ;:..- Z I
.' . . >J>::-=<::Tep
l1. - Lo..; A. B;R~~i-~<~W;NE 9hsJd, I
Signature of Owner or Authorized A Print !,,~ rn CO @ ~ Date I
OFFICE USE ONLY: *************************************<-,:i~~*i:~**************************~*****
SPE EQUIRED: Filing Fe€~ g ,.6. ~ r /1 ~ '
. Base Insp~iYr\s: r ;;; 7 7 '6 # Charged Re'
U per Footing r Slab '"6-;," ../'..J'--() Reviews
Cert of Occupancy: :::>, '.J '
26 . tfO
.50
TY,,oF CONSTRUCTION:
SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
[] RESIDENTIAL(For
Additions. Remodels. Etc.)
PROJECT INFORMATION:
Early Release
Permit:
_yL~
_y -.i'N
Lot Split:
TYPE
F IMPROVEMENT:
NEW STRUC'lJRE
o ROOM ADDI TON(S)
o ''lRCH ADDION(S)
CI , ~K ADDITF '~fS)
l R. ODE\.
.__~ ~2isement Finish only
U ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOUTION
Manufactured
Trusses:
L1L.-N
1Y_N
Sump Pump:
Site
P,R.I.F.:
~-"eVieWe<J/APProVe<J: Dept of Community Services
.. '---.i~/F,,","ILP RESIDENTIAL
(Date)
TAX MAP PARCEL #:
PLUMBING CONTRACTOR:
J>aW E. SMiTH
Plumber's Indiana State License #:
101177
Additional Fees
/;0
Date
Fee Received by: