HomeMy WebLinkAbout06090166 Application
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER
OF
RECORD:
NAME:
FAX:
Ii) .a.lt-031f"
ZIP:
7'6 a.3 d-.
....'" tt, u..M..Q C7V\L. L LC
STREET ADDRESS:
/3 /7 Md:Jl"" c.r.....,>
PROPERTY
OWNER:
/00
cm:
c..",r_l
STATE:
::r ,..;
Sfultn.lOA
BEST METHOD OF CONTACT:
_ <AWl G..II (311)il..~
PHONEr" 17'
L;, J 3i:2g7~
~
FAX:
STREET ADDRESS:
I~ / 13"..... tOr W
cm:
CQ....."""'f..,-1
STATE:
::r:;,V
ZIP:
l.( 60 31"3
WATER UTIlITY C . I
PROVIDER: "'....."""'t..
SECTION:
ZONING:
]\-).
SQUARE ") riCO
FOOTAGE: ()(J../
LOCATION
& PROJECT
INFO:
LOT #: SUBDIVISION NAME:
g I 13r.~ I.:.~kr"
ADDRESS OF CONSTRUCflON: I J 3 ~ I
SEWER UTILITY
PROVIDER: C
"l."-""'L.
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUN1Y WELL AND/OR SE C PERMIT #'S (IF APPLICABLE):
ESTIMATED COST OF CONSTRUCTION: .clIO
(EXCLUDING LAND VALUE) 1/ /00 ()(Jt), -;
I
B ASr- TAX MAP PARCEL #: I
,iJbieCtto <.::D~O ILP- JO-J~-O).,-'o,t>(!{.
TYPE OF CONSTRUC110N:-;:::;-';-~T.YPEcO:- fP1i<iflC9 CONTRACTOR:
..d _~ r;= \c., ,I ,'J ,=, ", II: <in 71'''''''-;-
o SINGLEI,FAMm:f:, \~~__0_~~-----o- . ' I3RCO~ Cll.oca . TUN ko r ~ __ 'v
o TOWN Hq!'l~\ r- Ii3 Rq M IftGI:ti$}" MUtv{'>P[ s State License #:;
o TWOFAMILY}\. ^Q. POR! Il\\DDmlS~l. I Y~;l?c
#ofu~i\i,'1~ing t>EP 29 'l.WP DE~,~4!jpmON(~ND /CLA.i,);:::r~9. 10,0 ~(lS-
ct,ons~r~~~\ a~t thO Iii!I REMObE~ F' . h 1.<11 tvr<! W"iQ~~~5 will be applied to the construction:
Ime. " _ Bas~ent InIS on y ,
fil!1 RESIDENTIAL\( or 0 ACCESSO Y BUILDING I!Il Intemat. ,Residential Code w/Indiana Amendments
Additions.tmodels. Etc~ _0 DEl'AEH GARAGE
o ATTACHED GARAGE 0 Uniform Plumbing Code w/Indiana Amendments
PROJECT INFORMATION: 0 DEMOLITION FOUNDATION TYPE: (Check all that apply for the new
construction area)
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPER1Y:
Early Release
Permit:
_y /N
_y ,/ N
Manufactured
Trusses:
Lot Split:
Sump Pump:
CRAWLSPACE 0 POST & BEAM PIER
o BASEMENT (WALKOUT:_y-.l.N)
,
For Single Family and Two Family dwellings, additions, remodels. and/or ac~fs~hr@
days of the date of issuance of the building pennit, and must be completed (Certificate 0 C P
structure permits are subject to the General Administrative Rules of the State of Indiana (See 675 lAC 12
completing construction.
I. the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alteration of a structure, or any change in the use of land or structur~s
requested by this application will comply with, and conform to, all applicable laws of the State of Indiana, and the ~Zoning Ordinance of Cannel Indiana - 1993" (Z-
289) and amendments, adopted under authority of J.e. 36-7 et seq, General Assembly of the State of Indiana, and all Acts amendatory thereto. I further certify that only
kitchen, bath, and floor drains are connected to the sanitary sewer. I funher certify that the construction will not be used or occupied until a Certificate of
Occupancy has been issued by the Department of Community Services, Carmel, Indiana. . I
??~ ~~~ p ~.~I~-<>,.~bc.rrv 9/M/t>~
Signature of OWner or Authorized Agent Print / Date I
I
OFFICE USE ONLY: ******************************~~****** ***************~**************************
INSPECTIONS REQUIRED: FIling Fees: ~,"3 6'. '7{) ,
. , Base Inspections: ~d...~ 00 # Charged Re.
Upper Footln Lower Footing U / ___ 3 ReViews
Celt. of Occupancy: /--7. S ()
IS valid only if construction commences withm 180
) within 18 months of the issuance date. Class I
r-egarding expiration time frames for beginning and
P.R.I.F'
,-
./
Additional Fees
Reviewed/Approve: Dept. of Community
S:Permits/FormS/ILP RESIDENTIAL
(Date)
/0<- 0
Fee Received y:
Date
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