HomeMy WebLinkAbout06100134 Application
City of Carmell Clay Township [;~ Permit #: QI.t / OM ,q.
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, 8r. Two Family: New Structures, Additions, Remodels, 8r. Accessory Structures
BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
8r. PROJECT
INFO:
STREET ADDRESS:
LOT #:
SUBDIVISION NAME:
PHONE:
FAX:
<;51\0 -
CITY:
'2. V I LL.
STATE:
::r::
ZIP:
'1:(oO-r
BEST METHOD OF CONTACT:
a
PHONE:
FAX:
cm:
STATE:
ZIP:
SECTION:
5003
ONING:
€SI\)~A.lTi~L
SQUARE S 'b
FOOTAGE:
ESTIMATEO COST OF CONSTRUCTION~
(EXCLUDING lANO VALUE) ., Lj CO C) 0 0
SEWER lITILnY
PROVIDER: C
NAME OF lITILnY EXCAVATION CONTRACTOR; PlAN COMMISSION I BZA I BPW DOCKET
NUMBERS; TAC DATE{S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'5 (IF APPUCABLE):
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY;
- Ol~ - OC:()
.,..- \
_-:,1 () S Ov
"'--/_"- " \'.\
TYPE OF CONSTRUCTION: /;; TYPE. OF IMPROVEMENT:
~ ~<~ '\ ""1 :;.......11\ III
SINGLE FAMILY ./- ,,::C' \, ';:'~ NEW STRUCTURE
..--- j';"~ ""<'_____'; -p- "l~ '"
TOWN HOM!,.-:>' ICrj ::';::/ 0 ROO!,! A.l?I?ITlON(S)
o TWO FAM,RY., \i},>::'- .R\WORc;:tlADDITlON(S)
# of unil!"b~l,ng \ co '~"'bEcK:~bI'Q:ON(S)
constrU~~~ ~t thiS,.:\ 0 RE~EL \
time: ,',v <. \. ~\, ~ Base'!)ent Finish only
o RESIDENTIALI(FOI\ _____0 ACC~RY BUILDING
Additions. Reltiodl.!s. Etc.l~ 0 DETACHED GARAGE
\~ 'v~ ..............0..... ATTACHED GARAGE
PROJECT INFORMATION:/ 0 DEMOLITION
\KN
/,'KN
Early Release
Permit:
Lot Split:
Manufactured
Trusses:
if X-N
~Y_N
PLUMBING CONTRACTOR:
'&R.\C-'E... 'SMllt"t t>I...UM.~\lo:\G
Plumber's Indiana State License #:
r-c.\ 0 \CO:t.\ \0
Which plumbing codes will be applied to the construction:
~ntemational Residential Code wI Indiana Amendments
o Unifonm Plumbing Code wi Indiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area)
o CRAWLSPACE 0 POST & BEAM PIER
o SLAB ~ASEMENT (WALKOUT:_Y ~)
For Sin 1.!X an wo Flfn!i.!Y. we .~-l,.qqi.ti.qWt"'fA?\wleIs. and/or accessory stru.ctures, this permit is valid only if construction conunences within ISO
days 0 fe.JAs~Pl:l~l\.Qgu'{r'd 19~~,~~mus?be completed (Certificate of Occupancy issued) within 18 months of the issuance date. Class I
structure pennitslDleStJ&je:~tb.lGaaH.z;~~stra~e Rule, s of the State of Indiana (See 675 lAC 12) regarding expiration time frames for beginning and
n~T Ill" rll~~AUNITY SERVICES completing construction,
I, the unMtst l~d,':(gree "th~ an1 constructio{1) reconstr~c~lj,Fnlirgement, relocation, or alteration of a structure, or any change in the use of land or structures
reques@t G)pp~R.M du~tG~JaJiliQW~ilta"pplicable laws of the State of Indiana, and the "Zoning Ordinance of Carmel Indiana - 1993" (Z'
289) and amendments, adopte41\1nS<<Al ~lfity of I.c. 36,7 et seq, General Assembly of the State of Indiana, and all Acts amendatory thereto. I further certify that only
kite , bath, and floor drains kt~ W~ne ("creo the s itary sewer. I further certify that the construction will not be used or occupied until a Certificate of
Dc 'Pancy,~as y by t De ent C mmunity Services. Cannel. Indiana. . \) I I
' . ~~lY\-L-'- S . Stt!\'FF~~ Tl<.[S \~ It 0(,0
Print I Date
Sump Pump:
/
OFFICE USE ONLY: ******,***************~***
INSPECTIONS REQUIRED: I.Q
~{er Fo~e~ ~ Unde ab ~ I'
c ROU9hjii>Q~ Final Site
.
************************
* ***j{****************
. au
i1ing Fees:
ase Inspections:
~?? )0
Sf. SO
P.R.I.F.: 1;2 6/ (J J
,;4 Yh~ c?-:(,; roo
JUi) ~ JI-<?-Ov
Fee ec ved by: Date
C/
ReviewedjAppr Dept. of Community Services (Date)
S;permlts/FomlsJILP RESIDENTIAL
~
# Charged Re-
Reviews
Additional Fees