HomeMy WebLinkAbout06100204 Application
City of Carmell Clay Township Permit # Ok> \ 002-olf-
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, &. Two Family: New Structures, Additions, Remodels, &. Accessory Struct~res
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BUILDER
OF
RECORD:
NAME:
jl, I.. s+ Lv.;' i
STREET ADDRESS:
," 'uLIO
WI'bfV
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~ .' ~,~;~: . ~BUILDER'S EMAIL ADDRESS:
.-....I!ii!! if.W".' .J. l .... 7'., I ,'( , . ,,_ -,
,r .~.:."t\..'*~~ ,\\\\,'" vA-- e '"' ~ .....,..,.. - F"-' ~
PROPERiY~'," ".NAME:
OWNER: ""I-k!u../ !l;1"vUC I '
PHONE:
317-Jrt/- ~u l. J
CITY:
LA-cM.,
FAX:
STATE:
T....
ZIP:
~01L
BEST METHOD OF CONTACT:
PHONE:
.1/7-52 -r/Lo
FAX:
STREET ADDRESS:
/V'ItJ OvA,,'oJ
/)", "
STATE:
'I-r
SECTION:
ZIP:
'(,d] L
'ADDRESS OF CONSTRUCTION:
l.../'-Iu I' .~
WATER lJT1LITY
PROVIDER: c..p.-c~ I
LOCATION
&. PROJECT
INFO:
LOT #:
SEWER UTILITY
PROVIDER: c.l A
8
SUBDM$ION NAME:
ZONING: . '
5 I
:rJ
SQUARE ~
FOOTAGE: ljuo
(4-J,...J
ESTIMATED COST OF CONSTRurnON: .:::-
(EXCLUDING LAND VALUE) '-I'I,~f!.:"'"'
Pi} r~~
//L//~~ If.?;;-..___..
TAX MAP PARCEL #: ~ I ~~ ~~~~,
PLUMBINGCONTRACTORl' ~J J ;_'j' /~j
Plumber's I (fjIj
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION I BZA I BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WEll AND/OR SEPTIC PERMIT "S (IF APPUCABLE):
FLOOD ZONE AREA DESIGNATlON(S)'v
FOR THIS PROPERTY: j\.
TYPE OF CONSTRUCTION:
o SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
+ RESIDENTIAL (For
Additions. Remodels. Etc.)
PROJECT INFORMATIO;(N:
Early Release
Permit: Y N
Lot Split: Y I~
),,'.-....
(/..r')~J
TYPE OF IMPROVEMENT:
o NEW STRUC11JRE
o ROOM ADDITION(S)
o PORCH ADDITION(S)
o DECK ADDmON(S)
o REMODEL
_ Basement Finish only
ACCESSORY BUILDING
DETACHED GARAGE
ATTACHED GARAGE
DEMOUTION
'$
o
o
o
, Manufactured
Trusses:
Sump Pump:
_Y~
_Y~N
o International Residential Code w/Indiana Amendments
o Uniform Plumbing Code w/Indiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area) 32\' '(/cVJ ,t(J"'f...J-
o CRAWLSPACE + POST & _ BEAM _PIER
o SLAB 0 BASEMENT (WAlKOUT:_Y_N )
For Single Family and_T~p,t.fqt,ilY " ,.alX.. .e el~.1"f d1i4t.iQU!i~elEcessory structures, this pennit is valid only if construction commences within 180
days of the date of i~cJi~n\.(Mb~Llt'~ t (Certificate of Occupancy issued) within 18 months of the issuance date. Class I
structure pennits ares~~;IJ'~'~' . ~Mlkt~I~-tiIIlUJ P~te of Indian~ (See 675 lAC 12) regarding expiration time frames for beginning and
'-01-SI8. '-'~itd~L.ocal Codes. completmgconStnlctlon.
I, the undersigned, agree that any cons c' _ '. -. acation, or alteration of a structure, or any change in the use of land or structures
,requested by this appliQ.Ef~tHeEp h ,<. . t , i s of the State of Indiana, and the "Zoning Ordinance of Cannel Indiana - 1993" (Z'
;. 289) and amendmen~dpQ;.~ . . :~'~t!f,tG)WIN. y of the State of Indiana, and all Acts amendatory thereto. I further certify that only
,f..'kit,chen, bath, and flo~H!al1sYlt-( e ~~tiTt~sewer.'1 Eu"rther ce, that the construction will not be used or occupied until a Certificate of
Occupancyhas been issued by the Dep IrlNO'.&fIrDfRunity Services, Carmel Indiana.
rtJ-I ' , OJ ' sJ-1J"" i 1 0/1, /0 to
Signature of Ownel" or Authorized Agent Print Date
.
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OFFICE USE ONLY: *********
*****************************************************
Filing Fees: /0 ~. if u
//f.{., ,)'J
I
5- 3 . 5-()
# Charged Re-
Reviews
Base Inspections:
Cert;-of Occupancy:
pper Footin Lower Footing Under Slab
~ Meter Base ~I Si0
,
CW.j:~ Hl:;~ \1-\0 -Of.,
Reviewed/Appr~ved: Dept. of Community Services (Dale)
S:Permits/Forms/ILP RESIDENTIAL
Additional Fees
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Date