HomeMy WebLinkAbout06100170 Application
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City of Carmel/Clay Township Permit #:()b) OO/'/(J
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
..,"'ILDER
OF
RECORD:
NAME:
B,,; de Pilei!: ",c 0 X",J :CCh
STREET ADDRESS:
52S1 N. ~(amQ... I-\~f
PHONE:
"/15 2S<f-~r;'L
CITY:
~"" e. 1 :InJla.... ./,j
FAX:
Uf- 40'10
ZIP:
46 22-0
BUILDER'S EMAIL ADDRESS:
:SD@ Gr,'<..j(.. V;/1 ,',.,J.., . c~
NAME'Sol" + ~W'j
SUBDIVISION NAME: A 1 _ '
~I'.SL\J\C.
ADDRESS OF CONSTRUCTION: .7 r I (J C
1.->10'1 "1 rreV1.Lhm
WATER UllLITY(J, ~
PROVIDER: _
7/\- ---"
PROPERTY
OWNER:
LOCATION
&. PROJECT
INFO:
STREET ADDRESS:
13 t/
LOT#: q5
SEWER lJT1
PROVIDER:
/;J
NAME OF UTILITY EXCAVATION CONTRAO'OR; PLAN COMMISSION I BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUmY WELL AND/OR SEPTIC PERMIT #'S (IF APPUCABLE):
:\1
"I ;':
~ Hi! l
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this pehnit 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 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 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 ert t at t e cons . not be used or occupied until a Certificate of
Occupancy has been issued by the Department of Comm ervices, Carmel, Indiana.
. C<.N../t Qu:
,..-
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY:
TYPE OF CONSTRUCTION:
o SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions. Remodels. Etc.)
PROJECT INFORMATION:
Early Release /{
Permit: _Y _N
Lot Split: _Y~.
SfATE':Trf
BEST METHOD OF CONTACT:
PHONE:
61,/. q" .M';X:<1dl
0'16 - . ...,/3 (. ,(gqS-IS'(,~
SfATE~rV" ZIPLi6 D 32-
~~hcJ, mo->-s
~e.
ZONING:
SECTION:
5-/
qIP
&-
SQUARE
FOOTAGE:
TYPE OF IMPROVEMENT:
'+ LUUO i : i ill
it:::)j
......J '
I
____J
PLUMBING CONTRACTOR:
L-N"1/t-.,
Plumber's Indiana State License #:
o NEW STRUCTURE
o ROOM ADDITION(S)
o PORCH ADDmON(S)
o DECK ADDmON(S)
o REMODEL ~~..1..~ Which plumbing codes will be applied to the construction:
_Baseme --fo F
.fll( ACCESSORY ~\b C crIP? ~~stional Residential Code w IIndiana Amendments
o DETACHED GARAGE ornpli"", "':-iN! l:PII~. .
o ATTACHED ~ Of State a =~n)fflmTi~lllf:Y1/ w/Ind.ana Amendments
o DEMOrna".y OF OF COMr;::,~/q{jlJ/fjli"J)EI(CheCk an that apply for the new
Manufactured ~F1~L /"if!Yi~
Trusses: _Y ~NOIA CLA.~TtJWN...::'ih, 0 POST&_BEAM_PIER
Sump Pump: _Y _N NA 0 SLAB ~/BsEMENT (WALKOUT:_Y_N )
loll-'1/o~
Date I
V"\
OFFICE USE ONLY: ********* ********t***'t.*****
INSPECTIONS EQUIREt] It <:
Upper Footing Lower ooting Under
-Meter Base
******************* ~C7******************
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53 - sO
Reviewed/Approved: Dept. of Community Services (Date)
S:Permits/FOfms/IlP RESIDENTIAL
# Charged Re-
Reviews
Cert. of Occupancy:
P.R.I.F.:
Additional Fees
,..,(J
10 ~~()
Date