HomeMy WebLinkAbout06110020 Application
SEWER lJTILITY WATER UTILITY ESTIMAn:~~ST OF CON
PROVIDER: CWI\'\.d vi-t \+I-eS PROVIDER: CA.lI^-ll 11+1\ ,hoil (EXCLUOI~""'NgVALUE)
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION I BZA I BPW DOCKET ,,~\S ~..~
NUMBERS; TAC DATE(S); ANDIOR COUN1Y WELL ANDIOR SEPTIC PERMIT #'S (IF APPLICABLE): : , e<1i / ~ . '. \1
FLOOD ZONE AREA DESIGNATION(S) "" G .~~ 1;, O"'~.s #: ~</\~'(S:3'~::\ ,.~\
FOR THIS PROPERTY: O"{... ,..0 'l'" ~\ <b~.;q' ,./ {\ ,:I ~/ ,.~~\ \\\
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMEN~ ~$l\\'I!' _"p~(J~tNGlc NTRACTO R: --:~,.;~;'/ r_ ,\:~' ~\ \
~~ 0" ,,~v c,;;;:;r- ,/ Ii "V,/ ~\)
o SINGLE FAMILY 0 NEW STRU ~O C ",,<1>,-eO~<' \ , <.e, '=';/ 1\ ~ '.,)
o TOWN HOME 0 ROOM AD ~) 0' ... (, il>Si Indiana State license'#:" -' I
o TWOFAMILY 0 PORCHADRijiON(S) 0' ...<f-.. ii!Y ....,\\ <\~ ~t'I
# of units being 0 DECK ADDiTION~"\ "CF ~ ' ':', ,) I.:; IV / '
constructed at this 'fV( ~MODEl t'f~~~' 0(1 Which plumbing codes will be'a'Pplled':tu the constl'~ion: ./" .'
time: / -.c>-BasementrlD ony ';,\\'\\\ / /" ,-..:,....-'
~ RESIDENTIAL (For 0 ACCESSORY Bun,'D NG 0 International Residential COde,w{Indiana jl,mendments ",.
Additions, Remodels, Etc.1 0 DETACHED GARAGE _ _ ';0 . /.
o ATTACHED GARAGE 0 UnIform PlumbIng Code w{Indlana Amendments
o DEMOLITION FOUNDATION 'TYPE: (CheCk~"~: apply for the new
construction area)
BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
& PROJECT
INFO:
City of Carmel! Clay Township Permit #:Q.b11.o.p.10
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICAtION
,
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Stru~ures
NAME:
M L.E:S
PHONE:
311 3St6 113 \
FAX:
S FUlwtZ/ZS
STREET ADDRESS:
I' 0 P E:c.os. c.+
CITY:
(ArM~
STATE: ZIP:
N '-1-10033
BEST METHOD OF CONTACT:
C-o I'\A h~ err ~MA d
ct'(\
NAME:
S~e 1\'> I\~
PHONE:
FAX:
STREET ADDRESS:
o () -P e:c.o C;
cm~\
STATE:
r-J
ZIP:
c.+
'3
LOT #:
.?-J...l
SECTION:
ZONING:
SUBDIVISION NAME:
C H EJ2./2.. c.. (2. E:'El(
~
~g~~~E: II q5:1 c;-
10660 ---
ADDRESS OF CONSTRUCTION:
!L.{-01C Pt2b":..
.~
c.+
Eany Release
Permit:
PROJECT INFORMATION:
Manufactured
Trusses:
o CRAWLSPACE 0 POST & BEAM PIER
o SlAB ~ BASEMENT (WALKOIJT:_Y$.-N)
For Single Family and Two Family dwelhngs, additions, remodels, and/or accessory structures, this permit is valid only if construction commences within 180
days of the date of issuance of the building pennit, and must be completed (Certificate of Occupancy issued) within IS months of the issuance date. Class I
structure permits are subject to the General Administrative Rules of the State of Indiana (See 675 IAC 12) regarding expiration time frames for beginning and
completing construction.
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alteration of a structure, or any change in the use of land or stru~tures
requested by this application will comply with, and conform to, all applicable laws of the State of Indiana, and the ~Zoning Ordinance of Carmel Indiana -1993~ (Z~
289) and amendments, ad ,'pted under authority of LC. 36~7 et seq, General Assembly of the State of Indiana, and all Acts amendatory thereto. I further certify that only
kitche , . th, and floo ' are connected to the sanitary sewer. I further certify that the construction will not be used or occupied until a Certificate of
Dee h bee i d the Department of Community Services, Cannel, Indiana.
-' l
Lot Split:
_YiN
XY _N
_Y -t"-N
_Y -$.-N
Sump Pump:
Signature
rvWI-eS
Print
s
(l~.ef <;
Nt'\! b, J006
Date f
OWner or Authorized Agent
OFfICE USE ONLY: ********************************************************!***~!******* ************
INSPECTIONS REQUIRED: Filing Fees: / 3 3 .) U
Base Inspections: ) I / (/ (I
') .3 _ :)'0
Under Slab
# Charged Re-
Reviews
Upper Footing lower Footing
~ Meter Base
Cert. of Occupancy:
Site
Additional Fees
P.R.I.F.:
(Date)
Fee Received by: