HomeMy WebLinkAbout06100095 Application
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\City of Carmel/Clay Township , Permit #P?:>/a t1 0 'IS
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'ESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
. Single Family, Multi-Family, 8r. Two Family: New Structures, Additions, Remodels, 8r. Accessory Str~ctures
i
_..lLDER of
RECORD:
NAME _
(:~T~'C>(,c L"-"T"M f.J.vME~
STREET ADDRESS
i1100 '-'_AY ~"..~,,<.c G.~v;:>
BUILDER'S EMAIL ADDRESS
owe.,p@ "~+..-id <C- <AM
NAME
PROPERTY
OWNER:
STREET ADDRESS
LOCATION
8r. PROJECT
INFO:
LOT #
51'!,
:sAJv..E A:i. Afj<.:.<';c
"
SUBDIVISION NAME
Vjl_LA~E of wes."( <'-'-^'1
ADDRESS OF CQNSTRUmON
/293 -4 T~1<t'( (I.ii, $Tl<<cc."'l'
SEWER UTILITY
PROVIDER:
CCAY
c:::~... 7---e../
WATER UTILITY
PROVIDER:
PHONE
FAX
815-ZSI~
(.,~9,-85~o
CITY
i.Jo/!,,",c<.
STAT~,J
ZIP .
4"J'L
BEST METHOD OF CONTACT:
l2.,..-K.:..,\
PHONE FAX
C';ELEA~Fn "'()~. e(fflS~~;:;;~~il
Subjec, r;,
- #; r;~ ~ ,_.SE;cnON ZONING:
O'..~~;:>; ;l~~,'t7ht., \r;t,SY".
, '._ _ ~ 1i4),WWSHIt'
CITY OF C~~I'.lEL I GLA. FOOTAGE: S855
ESTlMATEDCOST\OFicONSTRurnON:r'j\; .-,7 :,'::; , ',,-
(EXCLUDING [,ANi:! VALUE).""':"~:_:'m.i'",~'1 ~,,~:":" ,
,; I J! I ..----...., i .
IhS i -:if:' Cb/tJ(fCJ~
JeT )-V?"r'l'4i i OCT 2 "I 'Ii
j.. [r; ;11 lil
!,II II' I
PLUMBING CONTRACTOR: i tt.:-i/ I
I ~~'-'------_._~._-1
eTM-iU
Plumber's Ind'IaI1a-State'License'#: ---. _,_.i
NAME OF LJT1LIlY EXCAVATION CONTRACTOR; PLAN COMMISSION I BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'5 (IF APPLICABLE):
o CRAWLSPACE
Lot Split: _Y...25..N Sump Pump: -;t:.-Y _N 0 SLAB
Does any part of the property lie within a special Flood designation area: _Y..)LN
TYPE OF CONSTRUCTION:
~ SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units:
o MULTI-FAMILY
# of Units:
o RESIDENTIAL (For
Additions, Remodels, Etc.)
PROJECT INFORMATION:
Early Release
Permit:
_Y..LN
TYPE OF IMPROVEMENT:
,;g) NEW STRUCTURE
o ROOM ADDITION(S)
o PORCH ADDITION(S)
o REMODEL
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION
Manufactured
Trusses:
1...Y _N
luo 5t.o
Which plumbing codes will be applied to the construction:
~ International Residential Code w/Indiana Amendments
o Uniform Plumbing Code w/Indiana Amendments
(Multi-Family Construction Code)
FOUNDATION TYPE: (Check all that apply for the' new
construction area)
o
~
POST & BEAM
BASEMENT
WALKOUT:_ Y-;:>L--N
For Single Family and Two Family dwellings, additions, remodels, andlor accessory structures, this permit is valid only if construction commences
within 180 days of the date of issuance of the building permit, and must be completed (Certificate 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 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 that 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 of Occupanc.y has been issued by the Department of Community Services, Carmel, Indiana.
~ (L--z,.VLO.JOJ
Signature of Owner or Authorized Agent Print
OFFICE USE ONLY: ************
~
(Date)
Fee Received by:
/e'/il / of.
Date f (
Additional Fees
~ (b. ~tJ