HomeMy WebLinkAbout06100125 Application
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City of Carmel/Clay Township Permit #: Ole j ('{)/fJ._(
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
& PROJECT
INFO:
SEWER UTIliTY
PROVIDER:
NAME: I+cR..
BUILDER'S EMAIL ADDRESS:
e..~o<~\\t\c
PHONE:
FAX:
s.
L
CITY:
I0D6l
STATE:
-r-""
ZIP:
Lf IoOb '-
BEST METHOD OF CONTACT:
&L 71<0- tqI-D
QAvL.Qo",^-
PHONE:
FAX:
--rr(.",+~
STREET ADDRESS:
s: cf<{ r11e"",~'1'
SUBDIVISION NAME: 1 /J
UI \\q "- oP ytIlv- L.
Sif4
NAME:
R.o6c~
~,~~ eN~C
.-r<'~,{;~~;; \ \ E~f"'lATED COST OF CONSTRUOlON:
//; <,::..J! ~../\ \ -.(EXCliJDING LAND VALUE)
-<,"_/1 ,., .......1 ,/ .\\ \\\
NAME OF UTILITY EXCAVATION CO/'ITRACfOR: PLAN COMMISSION I BZA/:BPV:ioOcKET \'\ W\
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SE.P]1~P~~~:~;4!~~.:(IF'APPLlCABLE . ~ \~y) \
FLOOD ZONE AREA DESIGNATION(S) "'.'~\\</ \ \ TAX M~P PARCEL #:
FOR THIS PROPERTY: ';'\) l \ R,\ // 'tJ f' .3 <5
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT: / PLUMBING CONTRACTOR:
\\\ \\\ / /r'
o SINGLEFAMILY 0 NEWSTRUCT\l,RE / /GAKL M.\\<.A. ~~v,^,b\~
o TOWN HOME ~ ROOM ADDI1'~ON(S) ./ Plumber's Indiana State License #:
o TWO FAMILY 0 PORCH ADDITI.ON(~)/
# of units being 0 DECK ADDmON(S)
. constructed at this (lr'REMODEL
,./ time: _ Basement Finish only
rEf RESIDENTIAL (For 0 ACCESSORY BUILDING
Additions. Remodels. Etc.) 0 DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION
LOT #:
JS7
ADDRESS OF CONSTRUCTION:
WATER UTIlITY
PROVIDER:
PROJECT INFORMATION:
Early Release
Permit:
Lot Split:
_Y_N
_Y_N
Manufactured
Trusses:
Sump Pump:
_Y~
_Y vN
~tf <0 -
CITY:
STATE:
--r:-N
&
ZONING:
L..A.i.
c Co. (''^-<-
ZIPLj I.. 0:::2...
SECTION:
SQUARE
FOOTAGE:
/m
30 000 ~
Which plumbing codes will be applied to the construction:
o
tJ
International Residential Code w/Indiana Amendments
Uniform Plumbing Code wI Indiana Amendments
FOUNDATION TYPE:
construction area)
~RAWLSPACE
(Check all that apply for the new
o POST &
BEAM _PIER
o SLAB
o BASEMENT (WALKOUT:_Y_N)
For Single F~~~~~q.~~'lf~~iclldJor accessory structures, this permit is valid only if construction commences within 180
days of the d . sUM~eotthJ~ _b}!!lding~~ luid ':rrl.hit~pleted (Certificate of Occupancy issued) within 18 months of the issuance date. Class I
structure pe tMb~ttgmM€'rt'1f..{J A~ira6~ttS~e State of Indiana (See 675 lAC 12) regarding expiration time frames for beginning and
Of State and Local Codes. completing construction.
I, the undersi~p,. ~P~~U9R% f~\Ale~,m4~)q1ent, relocation, or alteration of a structure, or any change 1n the use of land or structures
requested by tWUQP.licatlOn wiltt:6rh\l1Y~Itl\! ~d cbn~/u'~l~~ble laws of the State of Indiana, and the "Zonmg Ordmance of Carmel Indiana -199r (Z~
289) and amel&lhl:dls,Q6P~~!1i~~ssembIY of the State of IndIana, and all Acts amendatory thereto I further certify that only
kItchen, bath, and floor drams are cOIlf*'f o..t.\1~samta'rysewer..ttUft'I\er certify that the constructIOn WIll not be used or occupIed until a Certificate of
Occupancy has been Issued?z the OetJ. h'J M Conunumty Services, Carmel, I~diana
~.-DJ?~ K." OOt.-LC Ac..,z, J{Nb-O(,
Si ature of Owner or Authorized Agent Print Date
OFFICE USE ONLY: **************************** ************ ************** ***************************
INSPECTIONS REQUIRED: Filing Fees: ,/33. S-o
Base Inspections: / (, t. <)0
Cert. of Occupancy: '5' J S tJ
Lower Footing Under Slab
Meter Base ~
P,R.I.F.:
# Charged Re-
Reviews
Additional Fees
ReviewedjApprov Dept. of Community Services
S:PermitsjForms/ILP RESIDENTIAL
Fe eceived by:
Date