HomeMy WebLinkAbout06100020 Application
City of Carmel/Clay Township Permit #: Oll/V()J^-O
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Fa ii, Town Home, &. Two Family:
BUILDER
OF
RECORD:
NAME:
[(7 "'1 6iH-Y
(./NI't tL>
STREET ADDRESS:
P6 iIl>~"3 Zc. '
BUILDER'S EMAIL ADDRESS:
PROPERTY
OWNER:
NAME:
7{,WbTf.I-'
STREET ADDRESS:
LOCATION
&. PROJECT
INFO:
LOU: 3~
SUBDIVISION NAME:
S It-PLlLBR.PM<_
SEWER UTILITY .
PROVIDER: L-r f( V ()
NAME OF UTILITY EXCAVATION CONTRAITOR; PLAN COM MISS
NUMBERS; TAC DATE(S); ANDjOR COUNn WELL ANDjOR SE
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERlY: VN S 1-+ A- P tZ 0
TYPE OF CONSTRUCTION:
'j1f SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions. Remodels. Etc.)
TYPE OF IMPROVEMENT:
~
o
o
o
NEW STRUCTURE
ROOM ADDITION(S)
PORCH ADDmON(S)
DECK ADDmON(S)
REMODEL
_ Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLmON
PROJECT INFORMATION:
_y~
_Y -1LN
Manufactured
Trusses:
Sump Pump:
_yjN
LY_N
Early Release
Permit:
Lot Split:
New Structures, Additions" Remodel~ &. Accessory Structures
c..1H.1- -v-I-/!'Fw (<€,'}O
PHONE: 'f If 3 FAX:
{..LC- 'I {, s;- - 1 ()CJ 0
CITY:
STATE:
ZIP:
?(tort:..
PHONE:
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~)~AX:',~
. "'~/ n..~~">"
"- /'~<'Z1;,., "'"
,-,<,' P:<~
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1// : t /'
CITY:
c, Z~ I
S T/~. LI ($ (S g.- CLYC
PLUMBING CONTRACTOR: ,-ViAl &fZ-l4--
Ie /zx;-- 60121
Plumber's Indiana State License #:
Which plumbing codes will be applied to the construction:
~ International Residential Code w/lndiana Amendments
o Uniform Plumbing Code w/Indiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area)
o CRAWLSPACE 0 POST & BEAM ~PIER
o SLAB tI!L BASEMENT (WALKOUT: Y Y_N )
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this permit is valid only if construction commences wit~ 180
days of the date of issuance of the building pennit, and must be completed (Certificate of Occupancy issued) within 18 months of the issuance date. qIass I
structure permits are subject to the General Administrative Rules of the State of Indiana (See 675 lAC 12) regarding expiration time frames for beginning and
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 structures
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"I(Z'
289) and amendments, adopted under authority of LC. 36-7 et seq, General Assembly of the State of Indiana, and all Acts amendatory thereto. I further certify tl'kt only
kitchen, 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 o~
Occupancy has been issued by the Department of Conununity Services, Cannel, Indiana.
~ 5-reY~ ~II- et€:-~Ee I()~ >-cb
Signature of Owner or Authorized Agent Print Date
OFFICE USE ONLY: ********* *********************~~****** ************'()(j?*7n**************~****
SPECTIONS REQUIRED: Filing Fees: , 4 - I
. . Base Inspections: ,;2 71, SO # Charged Re-
Upper FootlR Lower FootlR Under Slab ~ /0 Rev',ews
Cert. of Occupancy: . <; 3, ,J'
P.R.I.F.: / d-- (, I- dO Additio~al Fees
. to;"Jo .
(:1
Site
~~
mmunity Services (Date)
Date