HomeMy WebLinkAbout06100067 Application
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SEWER UTlLITY WATER UTlLITY ft _ _ I ".. ~. <,~~.. ESTIMATED COST OF CONSTRUCTION:
PROVIDER: PROVIDER: LU/..: ," .: ~" ~ ~EXCLUDING LAND VALUE) ()d tJ?f?J
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION I BZA rSPw D6a<.ET '-~~,::,-!) "
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT(!(s'(iF' APPUCABLE):--"::' /
I .." I ~ /
FLOOD ZONE AREA DESIGNATION(S) i<</~f? <'9 / TAX MAP PARCEL #:
FOR THIS PROPERlY: /7 0)
ift;;
r \'-"/1 I
TYPE OF IMPROVEMENT,(. PLUMBING CONTRACTOR:
/'-.Vl./// L' / r. () C
~NEW~RUiRE c:::s h 7 () 0 r J
o ROOI:'e.I:!DQ' ONeS) Plumber's I;iana State License #:
o PORCH'ADD' ON(S~ r r
o DECK ADDin6N(s):::) V/ I -17 ~r
o REMOBDEL ~t ~F" I Which plumbing codes will be applied to the construction:
_ asemen InIS on y
o ACCESSORY BUILDIN % International Residential Code w/India.na Amendments
o DETACHED GARAGE .' .
o ATTACHED GARAGE 0 UnIform Plum bong Code w/Indlana Amendments
o DE~ED FOR CON!nlBNlM1m~TYPE: (Checkallthatapplyforthenew
ManufactJ1w.1i>ject to compliance with'l!l~ftf~SlI1IItiPf!a)
Trusses: ~!lNJN1d Local Code5CJ CRAWLSPACE 0 POST & BEAM PIER
Sump Pu,,[jlEPT OFyC~MUNITY SE Ic;;g~ 0 BASEMENT (WALKOUT:_V_N)
!
BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
s.. PROJECT
INFO:
~ WS M\1) lo 1-\ [)
City of Carmel/Clay Township ~V\, ~LD\OUV Permit#: (j;/oo()&F/
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, s.. Two Family: New Structures, Additions, Remodels, s.. Accessory Structures
PHONE:
5'"? -k'Ooo
FAX:
$71- olP
ZIP:
ACT:
JJP-l j(JO
NAME:
PHONE:
FAX:
cm:
STATE:
ZIP:
STREET ADDRESS:
SECTION:
lOT #:
/-e
TYPE OF CONSTRUCTION:
o SINGLE FAMILY
~ TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions. Remodels. Etc.)
Early Release
Permit:
PROJECT INFORMATION:
Lot Split:
_v )(:N
_V.;t.N
For Single Family and Two Family dwellings, additions, remodels, andJorfN~2n\,WJctures, this permit is valid only if construction commences within 180
days of the date of issuance of the building pennit, and must be complett':d1Le'fti'fi~ffi of Occupancy issued) within 18 months of the issuance date. Class 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 Carmel Indiana - 1993" (Z-
289) and amen adopted under authority of l.c. 36~7 et seq, General Assembly of the State of Indiana, and all Acts amendatory thereto. r further certify that only
kitchen, b ,and fl r d re connected to the sanitary sewer. I further certify that the construction will not be used or occupied until a Certificate of
Occu/J cy y the Dep of Cot Servie... ~;r;;ar/? 7J af 6 Jd I (f - f'- Df,
Print Date
Base Inspections:
Cert. of Occupancy:
# Charged Re-
Reviews
P.R.I.F.:
Additional Fees
Reviewed/Approved: Dept. of Commumty Services
S:PermltsjFormsJILP RESIDENTIAL