HomeMy WebLinkAbout06100058 Application
City of Carmel/Clay Township Permit #:Db I (XJ058
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER
OF
RECORD:
NAME:
Il./~a:
PROPERTY
OWNER:
NAME:
STREET ADDRESS:
LOCATION
& PROJECT
INFO:
LOT #: '1. / SUBDIVISION NAME: \'./ t
/10 /Tct/l /~u,../
ADDRESS OF CONSTRUCTION:
t
SEWER UTIUTY
PROVIDER: C /( tJ l/
NAME OF UTIUTY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUN1Y WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE):
,~I.H1S lcukd
,)TYPE'OF IMPROVEMENT:
~/\\\ "
STRUCTURE
M ADDITION(S)
H ADDmON(S)
K DDmON(S)
EMO L
B ment Finish only
SSORY BUILDING
DETACHED GARAGE
ATTACHED GARAGE
DEMOLmON
TYPE OF CONSTRUCTI~N:.:..~;
~NGLE FAMILY/<-,Jo '10, ";;!J
o TOWN_Hg~E~ \~
o TWO:FAMILY-=-' c. 0
'#~f)aft,it5being c. ~" 0
co,:,~tructed at tpis ~ \) 0
tim~:)L\ 1.)1.:.'
o RESIDENTIAL (For
\,\ "\
Additions. Remodel
\\\ \>
\
PROJECTINFORMATlB :
Early Ri]' se ~ J
Permit: ~ / y ~
LotSp tV _v ~N
~N
~N
Manufactured
Trusses:
Sump Pump:
FAX:
Y(- '122 'I
CITY:
C1
,-..
~
BEST ETHOD OF CONTACT:
J__ E-/?1.a/ I
PHONE:
FAX:
CITY:
STATE:
ZIP:
?{
ZONING:
SEmON:
-:2-
Y~zy
(
SQUARE
FOOTAGE:
ESTIMATED COST OF CONSTRumON: 2
(EXCLUDING LAND VALUE) <r (j
::#="
~'" .i'
TAX MAP PARCEL #:
PLUMBING CONTRACTOR:
u/' I ("t.
Plumber's Indiana State Icense #:
/ rJ)~f r7 f
.
Which plumbing codes will be applied to the construction:
c::::?rrffemational Residential Code w IIndiana Amendments
o Uniform Plumbing Code wI Indiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area)
g--(RAWLSPACE 0 POST & BEAM PIER
~B QJlASEMENT (WALKOLrr:_v ~.
For Single Family an ~~ce~IJ~~[ fccessory structures, this pennit is valid only if construction commences within 180
days of the date of ~f~~~,[l!u'(~dirlJSl't{eYoid~f:Ni (Certificate of Occupancy issued) within 18 months of the issuance date. Class I
structure pennits are subject tB~l~~A~r':ilW~~taNV! Ri@}ls~bilmf$ate of Indiana (See 675 lAC 12) regarding expiration time frames for beginning and
are and"Local Codes. completing construction.
I, the undersigned, a~E:BTaQ~MIj\rITGqQff'lf\'lGI-i9.n~mt~enthrelocation, or alteration of a structure, or any change in the use of land or structures I
requested by this afP.:l;q;njo~ WJ~\ an'a CO'r!fbdn td, lili1pplkafSiOlws of the State of Indiana, and the ~Zoning Ordinance of Carmel Indiana - 1993n (Z~
289) and amendmeirt{ ~dbp'ticfU filt-ofl.eb.mtTe@~rar:~bly of the State of Indiana, and all Acts amendatory thereto. I further certify that only
kitchen, bath, and floor drains are connectm~'~SlllJi^ary sewer. ~ M~t'l!'e~ lllrtify that the construction will not be used or occupied until a Certificate of
Occupancy has been issued b the Departme'r{~'6f~unity Services, Carmel, Indiana.
7: -. -r:- ;? (. &-f(0 (T /o-6-o{,
re of Owner or Authorized Agent Print f Date
OFFICE USE ONLY: ************* ** * *** ******************************************** ************ ******
INSPECTIONS REQUIRED: Filing Fees: 51 ~ I. 7'0
- . Base Inspections: ~ '11. SO
per 00 Ing wer Footing Under Slab "'3 SO
Cert, of Occupancy: v'
P.R.I.F.: /'l,.(QL. 0 fJ
~TOTAL: 4\ A~/3.LfO
'_ )/1 If?; L7 (( :11. d
Fee Recelv : v I 011 J I b~"L-- Date
Site
kl~
lo-q-Ob
(Date)
Reviewed/Appr ed: Dept. of Community Services
S:Permits/FormS/ILP RESIDENTIAL
# Charged Re-
Reviews
Additional Fees