HomeMy WebLinkAbout06100152 Application
~...........\
.@"'.""'"
.. 'It-p< \\
,. I
\ - ,
\ ,t M ~ /
"'/~OIAMJ,//
City of Carmel/Clay Township Permit #{JfaIDO/5d'-->"
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:
NAME:
R,
STREET ADDRESq 0;)5
BUIlDER'S EMAIl ADDRESS:
f
NAME:
STREET ADDRESS:
LDH: ~()
ADDRESS OF CONSTRumON:
SUBDIVISION NAME:
SEWER LfTILITY
PROVIDER: (}, \~
WATER lJT1lITY ,^ /'::;1
PROVIDER: eM\! tc-j
FAX%If&i 'UtI'
FAX:
STATE:
ZIP:
ZONING:
~g~~~E: L/ 'JJ ~ 0
ESTIMATED COST OF CONSTRUCTION: a. LaO OaJ
(EXCLUDING LAND VAlUE)._.
I-~,--'._--:-""~ -
!i!:) l!;,-'i:~~db~loo';50
, 78),,-- '"
TAX MAP PARdr'tf#) I I i.i '
Iii OCT 1 9 2006 ,i! it;
,w.le" J'~I'
PLUMBING CONTRACTuR.:_ ~j
Plumbe~~a[~: ~ . .
ItJ5CtoC1
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA I BPW DOCKET
NUMBERS; TAC DATE(S); ANDIOR COUNTY WELL ANDIOR SEPTIC PERMIT #'S (IF APPUCABlE):
TYPE OF IMPROVEMENT:
ft NEW STRUCTURE
o ROOM ADDITION(S)
o PORCH ADDITION(S)
o DECK ADDITION(S)
o REMODEL
_ Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION
TYPE OF CONSTRU
~INGLE 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:
Lot Split:
y~
yA
Manufactured
Trusses:
Sump Pump:
~_N
0_N
A{ 5
Which plumbing codes will be applied to the construction:
o International Residential Code w/Indiana Amendments
~niform Plumbing Code wI Indiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area)
o CRAWLSPACE 0 POST & BEAM PIER
o SLAB BASEMENT (WAlKOUT:_y--'l-N )
For Single Family and Two am elfi ~s, aadtlio s,' 00el.'" l 'a e structures, this pennit is valid only:if construction commences within 180
days of the date of issuanc 'ili@9liitamg':'ptrilrit~arufhlli~i-Jb€cbmpJtW&.tlOM6ficate of Occupancy issued) within 18 months of the issuance date. qass I
structure pennies are subject to the G~rn~~sJ:r!!.ti~:'But~~t....t.h~ State of Indiana (See 675 IAC 12) regarding expiration time frames for beginn~ng and
nl=PT nr: ("'n~A^ "''-''T'' ~~,,*lil}!!F"~truction.
I, the undersigned, agree that"'<th'y"torfstM-tiotr:'rttOnStliietion\ enlargement~ttlec:~tah, or alteration of a structure, or any change in the use of land or structures
requested by this applicati~Yo€PlY '@ArMfP.:rt?tjn@t:)lapp~caW~tr4'c::tt.t~tate of India~a, and the "Zoning Ordinance of Carmel Indiana - I?93" (Z-
289) and amendments, adopted under authority cif Lc:.,~_~-7 ekseg, Generat ksemSfy Jt ~he State of IndIana, and all Acts amendatory thereto. I further certIfy that only
kitchen, bath, and floor drains are connected to the ~~'ri.italfse..u.... I further certify that the construction will not be used or occupied until a Certifi"cate of
Occupancy has ",en is e b the epartment of Conununity Services. Carmel. Indiana. I
I I j . 10'(') 10, lStrDcf' /O-I~
Sign re 0 0,' or Authorized Ag t Print ~ Date
OFFICE USE ONL V: ***************************** ****************************************************
INSPECTIO REQUIRED: Filing Fees: ~~ rJ(J~
F t,.- L ~F t"c Under Slab Base Inspections: :::> ~.5 {J # Charged Re.
pper 00 mg ower 00 mg ReVlews
Cert. of Occupancy; S :J, -(0
P'R:I.~': /0' c; I j! tJ
~ TOTA~: / 'ciZ7Z
//&u 'y-
_[? J /O~?-<<-v
~-iwe jApprov d: Dept. of Communitv Services (Date)
lits/FOflllS/ILP RESIDENTIAL
,
,
I
Additional Fees
, rJ()
Fee Received by:
Date