HomeMy WebLinkAbout06100192 Application
ESTIMATED COST OF CONSTRUcnON; ./~r\
(EXCLUDING LAND VALUE) 9' ~f,='~",\\~\\
rit:te,., .::tFObto/}~~b~1 \'<;:"'~
FLOOD ZONE AREA DESIGNATION(S) (J / TAX MAP PAR,CEJ'.#: <<, ~\j. R:l '\ m
FOR THIS PROPERTY: ~ \ \ \' \S .~" \~
TYPE OKONSTRUCTION: ~~ER"fl\J. ~UMBING CONTRAcro
9""5INGLE FAMILY f\E.\..~~e a\l~:~~\aUo'}A (J, .J,...ck s ... \
o TOWN HOME SUtl\OCOP'ltem. -r,m,... ~~oo R"lc<lllbniber's Indiana State Lic e
o TWO FAMILY eel 1?OI<<:H Au p!'tfSr\:.' CoO',
# of units being . .,q..\t"~19~OO" N(~I;OWN \P~?'1-'O. bJ:';:,
/:;:yucted at this DE? ~~- ~.~~~~jlL I C~~: only Which plumbing codes wHl be appli the construction:
(]J/RESIDENTIAL (For Cli'i 0 ACCESm_ING ~ional Residential Code w/Indiana Amendments
Additions. Remodels. Etc.) 0 DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION
BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
&. PROJECT
INFO:
City of Carmel/Clay Township Permit #/)t, / 00 ICj;)
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
NAME:
/ PHONE:
f.;-.J = D .!U....v- c...:,,,,s;+ rU.<: \"'",,,, So?
FAX:
rlC;~ S] 6 -0 (J
STREET ADDRESS:
f D ~-yx.-
CITY:
"7--,' ~.JJ.11r
STATE: ZIP:
.-+,sD
,f" 0 7
BEST METHOD OF CONTACf:
"{.., .s 3)'
PHONE:
FAX:
'ii({,.-oSl'i:!
C~
~.-p, WC,J f-. SECTION:
)00..1
STATE:
~
LOT #: '36 If
SUBDIVISION NAME:
u: {, 4-tk
7 ;L >f'
SQUARE
FOOTAGE:
O~t-J
SEWER UTILITY
PROVIDER: C. r (2 eJ ,)
tJ~C-J
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET J I
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'$ (IF APPllCABLE): U
o Unifonn Plumbing Code w/lndiana Amendments
_Y~
_Y.1LN
FOUNDATION TYPE: (Check all that apply for the new
construction area)
PROJECT INFORMATION:
Early Release
Permit:
Lot Split:
Manufactured
Trusses:
Sump Pump:
v? V" N
Y_N
o CRAWLSPACE 0 POST & _ BEAM _PIER
o SLAB ~ENT (WALKOLrr:_Y ~
For Single FamiJy and Two Family dwellings, additions, remodels, and/or accessory structures, this pennit is valid only if construction commences within 180
days of the date of issuance of the building pennit, and must be completed (Certificate of Occupancy issued) within 18 months of the issuance date. Class I
structure permits are subject to the General Administrative Rules of the State of Indiana (See 675 lAC 12) regarding expiration time frames for beginniJ:ig and
completing construction.
I, the undersigned, agree that any construction, reconstructi ~ent, relocation, or alteration of a structure, or any change in the use of land or structures
requested by this application will comply with, and conf to, all applic e laws of the State of Indiana, and the "Zoning Ordinance of Cannel Indiana - 1993''' (Z'
289) and amendments, adopted under authority of I. 6'7 et seq, General As mbly of the State of Indiana, and all Acts amendatory thereto. I further certify that only
kitchen, bath, and floor drains are connected to the nitary sewer. I further ce that the construction will not be used or occupied until a Certificate of
O~cy has been issued by, the De tment Commu~ty Services, Cann . Indiana.
~,~ vcJ. \"J-'. j /,.
Signature of Owner or Authorized Agent /Print
-"oJ-g u kG
J".e /
OFFICE USE ONLY: *************
# Charged Re.
ReViews
Additional Fees
53, ytJ
Re,lewed/Appro,ed: Depl. of Community Services (Date)
S:PermitsjFormsjILP RESIDENTIAL
Fee Received by:
Date