HomeMy WebLinkAbout06100015 Application
City of Carmel/Clay T~wnship c}.. Permit #: cJ&/1J mJ IS
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER
OF
RECORD:
NAME:
/I"ty/~
STREET ADDRESS: ,~
c.,~ ~ e. 7<:> ----$'-l00
PHONE:
8<f.:l -ltf" 7.::J ~
FAX:
f?</;}- 1r cJ ~ ~
CITY:
?},d ~
STATE:
...z ../
ZIP:
cV&..;ln
BUILDER'S EMAIl ADD~ES7
.A/ W'or Q'" ~ S;/v~ ~l1eh
BEST METHOD OF CONTACT:
e~Q.-\ \
PROPERTY
OWNER:
NAME:
STREET ADDRESS:
RfYle
/r
LOCATION
&. PROJECT
INFO:
LOT #: SUBDIVI~ION NAME:
0/ A btrd("t!'l
ADDRESS OF CONSTRUCTION: \ 'J.'1 q9
SEWER UTILITY
PROVIDER: C7/l. t.J 0
WATER UTILITY (] IJ I
PROVIDER: Co,,""'-I(
PHONE:
t(
FAX:
Ir
/j
CITY:
If'
STATE:
",
ZIP:
/1
SECTION:
ZONING:
S-j
SQUARE tpl/dG
FOOTAGE:
0v-~\ L\l..~3~
ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE) ;;)41,.)0 c
eJf<:!.. tUi/ScvJWa.!- ~vJ"'-
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPUCABLE):
FLOOD ZONE AREA DESIGNATION(S}
FOR THIS PROPERTY: c.....
TYPE OF CONSTRUCTION:
~SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions. Remode's. Etc.)
TYPE OF IMPROVEMENT:
ri>L NEW STRUCTURE
IS-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
PROJECT INFORMATION:.
Early Release / Manufactured V
Permit: _y 4 Trusses: ..,L:::;.Y _N
Lot Split: ---ml~ED.,~ ~~ST~TI~~
For Single Family and ~y~~t~l>.rteJLti.ge!!!lrt~@j.s..and/or acceS:Sory structures, this pennit is valid only if construction commences within 180
days of the date of issuance of t~IWtrd.f!fj~.pw~'-~\ls.tJla ~9WP~et:tificate of Occupancy issued) within 18 months of the issuance date. Class I
structure pennits are s~~~tt~~e6}fal~~'ttb.ti* Mfes b(thl(~a~j2.nndiana (See 675 lAC 12) regarding expiration time frames for beginning and
" ;....("'''c:~Ar-1 I CLAY 10ipi>IiIGlrldl!f,mtruction.
I, the undersigned, agG~Thaqro~~t~~n', ~~nsttu.ction, enlargement, relocatibn, or alteration of a structure, or any change in the use of land or structures
requested by this application will complywithl~lA"NHto\ all applicable laws of the State of Indiana, and the "-Zoning Ordinance of Cannel Indiana -1993''' (Z'
289) and amendments, adopted under authority of I.c. 36-7 et seq, General Assembly of the State of Indiana, and all Acts amendatory thereto. I further certify that only
kit<:hen, bath, and floor drains are connected to the sanitary sewer. I further certify that the construction will not be used or occupied until a Certificate of
. Occupancyhas been issued by the Department of Community Services, Cannel, Indiana. AJ,,4- P
.h~--" Zc /(,.d 'fi/e/-111I
f..,':.'.--'
Sig
Print
TAX MAP PARCEL #:
PLUMBING CONTRACTOR:
;:rr 15 ({y, frac.hd
Plumber's Indiana State License #:
~/()b qs- ~O
Which plumbing codes will be applied to the construction:
~Intemational Residential Code w/Indiana Amendments
o Uniform Plumbing Code wjlndiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area)
o CRAWLSPACE 0 POST & BEAM PIER
o SLAB )( BASEMENT (WALKOUT:_Y~ )
2- ::JJ-D6
ate
OFFICE USE ONLY: **************************** **~~******~*************:Jof7***o****************
SPECTIONS RE UIRED: Filing Fees. LJ /'~
Base Inspections' ,;;;!:2 7 .5 V # Charged Re-
pper Footin ower Footi Under Slab . ~ _ I / (}G r-O Reviews
(:,__.- -~ Cert, of Occupancy: -=' 7? 'i \5 . ~ .
00U9h V ~ Sit':.-/ P.R.I.F.: 7~ 1:;) GO Additional Fees
I '0-5- ~TOT L~. ~n?vK3.6o
ept. of Community Services (Date) " . ~
S:Permits/Forms/ILP RESIDENTIAL Fee Received by: Date