HomeMy WebLinkAbout06100169 Application
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BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
&. PROJECT
INFO:
....~eJitQ
City ofCarme/lClay TownshtjJ,"'aII;'<. Please call 695-7630 for Permit #06100/61
RESIDENTIAL IMPROvEKmNT LOCA!!fi'6N PERMIT APPLICATION
For Single Family, Town Home, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
NAME:
Dfty /l-1 (.l-RL
PHONE:
1'7 gf/? bi.f'tD
CnY:
~1V6A/Pl.,. :).
FAX:
JI7 5"75- ?fly~
/.ft>A4 e 5
STATE:
rlU,
ZIP:
if't,. 2-86
STREET ADDRESS:
9fil0 . PV&ll.. Olllvl:
BUILDER'S EMAIL ADDRESS: BEST METHOD OF CONTACT:
.::rS'ffi P'(...f Y@I)/l1)/1Af1.t:Ut.9A4Ef . COM
NAME:
PHONE:
FAX:
3 '7 SIr- $t'f?
1/'/11) ~
STREET ADDRESS:
11-5 .f.l.l3tJv6
CnY:
STATE:
ZIP:
LOT #:
815'
~/UBDIVISION NAME: i I
Y Wfff c"--!I- >'
SEmON:
I ,,"'c> 2-
ZONING9//l
SQUARE
FOOTAGE: 92..1 D
ADDRESS OF CONSTRumON:
('2-z...S7 !10Arre-'r-}j..M
S'1:
ESTIMATEb COST OF CON~RUCTION:
(EXCLUDING LAND VALUEjI' 7 S- tJ ,oe>o.
1<lfC/lllll-rtll.lr
.' OCT 2 3
SEWER UTIliTY WATER UTILITY
PROVIDER: c:.t.~y "";./11/51111' PROVIOER: c.A M" L.
NAME OF UTILnY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET n+ f3
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE):
TYPE OF CONSTR
rz{ SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions. Remodels. Etc.)
TAX MAP PARCEL #:
J
PLUMBING CONTRACTOR:
'- D H cCIf A A.JI en- L
Plumber's Indiana State License #:
NEW STRUCTURE
o ROOM AOOITION(S)
o PORCH AOOmON(S)
o DECKADOmON(S) Pc:. 8101:, 'frLf 0
o REMODEL . . h I Which plumbing codes will be applied to the construction:
Basement FIMlS on y ...~
o A<\Q!!!!!!.~t!QJOlJNGR CO!p yntMlaiTd,Qlitesidential Code wi Indiana Amendments
~ $-~~~gl~fu!i"nC0 w;tb~i'J~$'n\lI~Mg:/'~ng Code w(Indiana Amendments
o ~EMOLITIO~''g\<gf" and Loc~l Codes
DEPT OF COMMUNIT'I'IJUllt.......QN:;ryPE: (Check all that apply for the new
Manufil6PndOF rARMEL I CLA'r~f'ftl>
TrusseS'!"" ...!::...'i ~DiANA 0 CRAWLSPACE 0 POST&_BEAM_PIER
Sump Pump: ~Y _N 0 SLAB erBASEMENT (WALKOUT:_Y ..-,.()
PROJECT INFORMATION:
Early Release
Permit:
Lot Split:
Y /N
-y:/r::
for Single Family 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 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 oon~truction.
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 I.C. 36~7 et seq, General Assembly of the State of Indiana, and all Acts amendatory thereto. I further certify dllit only
kitchen, bath, and floor drains are connected to the sanitary sewer. I further certify that the construction will not be used or occupied until a Certificate of
Occupancy has bee Issued b the Department of Commumty Semces, Carmel, Indiana .
'1M..V. (j-/f'.1.t,.. ::r~t:= p.A.C G,ltJl.~Y, f1S ftlo/?A)T IP/U:>/t>"
51 ture of Owner or Authorized ~rint ,cCJ Ii. I}... j I?t}iulld ate '
* *************************************************************
. /3/0.60
d77 .)()
Cert. of Occupancy: ..).3::;-0
P.R.I.F.: / OJ- C / (J 0 Additionai Fees
# Charged Re-
Reviews
(10
'--'
. of Community Services (Date)
S:PermttsfForms/ILP R IDENT1Al
Date