HomeMy WebLinkAbout06100064 Application
BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
&. PROJECT
INFO:
City of Carmel/Clay Township Permit #: ()~IDI) 0(0'-(
I
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
I
For Single Family, Town Home, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
NAME:
PHONE:
Sli'- '8'Q{)(7
FAX:
57.3'-8"/
STREET ADDRESS:
132."1S ,lYJu,;J,'..", L4rMJt-J j]/t-L
BUILDER'S EMAIL ADDRESS:
tJa v.:JKk;'" CM'1. 0 "1
NAME:
CrrY:c 1Vr'""" (
ZIP:
v' {6,1,-
STATE:
7/1/
BEST METHOD OF CONTACT:
c;,sa -SOI!>~
PHONE:
FAX:
Q-n><.. ~J a 6""-<-
STREET ADDRESS:
eTIY:
STATE:
ZIP:
LOT #:
10
./
~
SECTION:
T
ZONING: ;!JeAO
ADDRESS OF CONSTRUCTION:
18(,1 r~/-e,."t9 CdV-r
SQUARE
FOOTAGE:
WATER UTILITY
PROVIDER:
ESllMATED COST OF CONSTRUcnON:
(EXCLUDING LAND VALUE) / (/ tJ () () 0
TAX MAP PARCEL #:
TYPE OF CONSTRUCTION:
o SINGLE FAMILY
cs--1'OWNHOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions, Remodels, Etc.)
mber's Indiana State License #:
whHi ..'1$ y-
o I
Which plumbing codes will be applied to the constr-uction:
~mational Residential Code wI Indiana Amendments
Y~N
_YAN
ent Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE .. .
o ATTACHED GARAGE 0 UnIform Plumbmg Code w6~hana Amendments
o DEMOLmON ~Ci\
~::r.,:':;:~lft'e' ~\ill.~i1111 that apply for the new
Manufactured /~L~SC \iam!8'W\~ ,~e~
Trusses: _Y ----s \ect t~ ~~;'~ ~~ ~&\i~'ER\j~85ST & _ BEAM _rIER
Sump Pump: _Y - 0 f CO~~\'{ i~~~LKOUT:_Y------;N)
PROJECT INFORMATION:
Early Release
Permit:
Lot Split:
For Single Family and Two Family dwellings, additions, remodels, and/or a~rn~' s~V~aJ.id only if construction commences wit~n ISO
days of the date of issuance of the building pennit, and must be compleGl(I:~dtj'cate of Occu~\::t\~h~B-J within 18 months of the issuance date. Class I
structure pennits 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 al teration 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 Carmel Indiana - 1993~ (f:-
289) and ame nts opted 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
kitchen, ba , a fl drains are nn to the nitary sewer. I further cer' that the construction will not be used or occupied until a Certificate of
Oeeupan i"ued by. e tmen f 'ees, C e ,I ian~ / i? ~~ /0 --9~d (
I
OFFICE USE ONLY: *************** **** **********************************Z*l***'1J**************1****
INSPECTIONS REQUIRED: Filing Fees: {5 g: j I
. .:;::::::::==-- Base Inspections: ..;J "2 7- :)0 # Charged Re-
Upper Footing Lower Footln Under Slab c. '~'/"3 :f () Reviews
~ Cert. of Occupancy: ~ _ .
P.R.I.F.: /;;;z r:; ( ~ . Additional Fees
OT AL' ..2".2. GO. .so
, If) I
Print
Date
(Date)
"viewed/Approved: Dept. of Community Services
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'mitsfFormsflLP RESIDENTIAL
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