HomeMy WebLinkAbout06100112 Application
\
\
"
~
lfnDCLd J, J,{} 7- J1U)lLh /Jlc j)
City of Carmel/Clay Township (i...aA/1,~lq) Permit #: oCt ( () Ofl~
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER of
RECORD:
NAME
STREET ADORE
PHONE
FAX
Shannon Hinshaw
40 Allison Polnte Blvd. #20Q:m
PROPERTY
OWNER:
WATER UTILm (},-, , I/VI /J "
PROVIDER: U/l/ / ~
TYPE OF IMPROVEMENT:
'isJ NEW STRUCTURE
o ROOM ADDITION(S)
o PORCH ADDITION(S)
o REMODEL
o ACCESSORY BU1LDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOUTION
STATE
ZIP
BUILD~B'X~"3'~806_2941 Fax 317-842-3389
BEST METHOD OF CONTACT:
STREET ADDRESS
LOCATION
&. PROJECT
INFO:
SEWER lJTIlITY
PROVIDER:
SECTION
-J
ON . A/vJ tlaJurld IN. 4utJ3J--
PHONE
FAX
cm
STATE
ZIP
ZONING:
SQUARE I) 7/ /i-
FOOTAGE: d1 L..f c>
NAME OF IJTlLm EXCAVATION CONTRACTOR; PLAN COMMISSION' BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE):
.; Manufactured V
_ Y ~N Trusses: /' Y N
V --y- 0 CRAWLSPACE 0 POST & BEAM
Lot Split: _ Y --D-N Sump Pump: Y A.,.N ~ SLAB 0 BASEMENT
Does any p f f!Ii<tm~~q;ICIlClllod designation area: _Y LN___W~KOl!'":;,,~.-Y,_N
For Single F~~T~(UHffim~'g'WentH~tJ:afiUitp'~~, ~eA?o els, and/or accessory structure~~h"i~:~[~it~~a~~~~n'I~ if:~~~\~~,c\~!~o~ 'fpmmences
within 180 days of th't4~a'tfB~arlde0CiliJkHMu'g permit, and must be completed (Certifi~ate, oLOccupancy issued) within 18 mqn,ths of the
issuance date, CHrrc;~~%WJ1Ut~f1f~qsF!Wt/twe. SI.Ad,ministrative Ru~es of the SfH~)9f\lndiana (See 675 lAC 12) reg.~~diN~,eXPiration
, Dl::t-' _, l\"IPe.r~tJ~~'lDnmg and co~pletmg constru~tl!Z'1', ') ?nrif; \ \ \ \ 1\
I, the undersVYl~!@fi:l@:A1ij,M_E.b.Jt\.ai\;-f:Mmh\-6~tYdrll,~argement, relocatIOn, or alteration hfia ~~rpctu~ GJan~change\.f:i{rhe use. <2Uaqd or
structures requested by this apphcal~~~ly with, and conform to, all applicable laws of the St~te dNndiana, and the "Zoning Ordi~ance'of Carmel
Indiana - 1993~ (Z- 289) and amendm~l\ts', ladopted under authOrIty of I.C. 36-7 et seq, General Assemb:tY,M ~he State olJ.ndiana,-and'all~Acts"amendktory
thereto. I further certify that only kitchen, bath, and floor drains are connected to the sanitary sewer. qfurthe'fcertify that the construction wil~'hot be
use or occupied until. C ei{jcaee of Occupancy has been issued by the Department of Commumty Services, CarmeJ, Indiana, .... -'~-.
. J- df/iJ/l/A/{)A! )f.LNJlllJVI--- /0 -ltJ-a
Sig ture f ner or Author' ed A ent Print - Date
TYPE OF CONSTRUCTION:
;go SINGLE FAMILY
TOWN HOME
o TWO FAMILY
# of units:
~MULTI-FAM~
# of Units:~
o RESIDENTIAL (For
Additions, Remodels, Etc.)
PROJECT INFORMATION:
Early Release
Permit:
11'3
PLUMB~N CONTRACTOR:
L(fI QD/U-
Plumber's nd,ana State LIcense #:
,I OJ/J()() 6"7
Which plumbing codes will be applied to the construction:
C)(.rnternational Residential Code wjlndiana Amendments
o Uniform Plumbing Code w/lndiana Amendments
(Multi-Family Construction Code)
FOUNDATION TYPE: (Check all that apply for the new
construction area)
OFFICE USE ONLY: *****************************************************~******************
Filing Fees: ~ (Q _~ . 60
I~P_EcnONS REQUI~~_ r-) '7 7, ~o # Charged Re-
Base Inspections: ~ _ _ u
per Footi Lower Footing Under S r'3 . .510 Reviews
Cert. of Occupancy: >0
6ete;B~al - Y P,R,I.F,: S 2, 7 . 00 Additional Fees
.5
~
(Date)