HomeMy WebLinkAbout06110064 Application
. ;-J"ll~\J
--'-"/~
'--"'>n:~", ."".,~""""
City of Carmel/Clay Township Permit #: OfolltJObf
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, So Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER of
RECORD:
NAME _ .
l:S'f(<IC>L,e 0&-0'-P
)
BUILDER'S EMAIL ADDRESS
PHONE &~tJ-es/O fAX
s: 3
r cl STATE ZIP
13(", I;J 41,
BEST METHOD OF CONTACT:
If) r? ,,'I!t? r ;f.,.9-f)5/~
PHONE fAX
STREET ADDRESS
PROPERTY
OWNER:
NAME
~7rRl D&.t
STREET ADDRESS
CITY
STATE
ZIP
LOCATION
& PROJECT
INFO:
lOT #
a..
SUBDIVISION NAME - , I A J I
bRt1r'DI,J '1ldf
SECTION
ZONING:
(
ADDRESS OF CONSTRUCTION
II/S 0 II. ,J
SEWER lJT1LITY / I
PROVIDER: <- p t< IUb
NAME Of UTILITY EJ!C1A~ n~QIffilA~OI';rr"l\N1"q'1~IISS!t?N/; BZA / BPW DOCKET
NUMBERS; TAC DATf\S); Nb/OR ~WELL AN.o/OR_S_~'Wc, ":~RMIT #'S (If APPLICABLE):
11[ Iii Iii
ON: TYPE OFIIMPROVEMENT:
NOV 1 4 ~ N~ #jRUCTuRE
o RQOOI ADDITION(S)
EJt'bRCH~DDITION(S)
o REMO L
ACCES ORY BUILDING
o DETACHED GARAGE
o ATIACHED GARAGE
o DEMOLITION
SQUARE
FOOTAGE:
$-
ftq'-lf;;
~ 75: ~GJ{)
/10
ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE)
/J1RL~/ll
'#
1/
,
PLUMBING CONTRACTOR:
K T /fI(l:ItH!
Plumber's Indiana State License #:
c'lg/IJo5z.o<)
o
Which plumbing codes will be applied to the construction:
"r)'i International Residential Code w/Indiana Amendments
o Uniform Plumbing Code wI Indiana Amendments
(Multi-Family Construction Code)
o
PROJECT INFORMATION:
Early Release
Permit:
Manufactured
_ Y XN Trusses: ')( Y _N
o CRAWLSPACE
Lot Split: _ Y --$N Sump Pump: -X- Y _N 0 SLAB
Does any part of the property lie within a special Flood designation area: _ Y .K.N
FOUNDATION TYPE: (Check all that apply for the new
construction area)
o
~
POST & BEAM
BASEM ENT
WALKOLIT:_ Y---1LN
For Single Family a.nd Two !:.ap.. .~ iI. /..W.v... " tll~... ,~'. accessory structures, this permit is valid only if construction comm~nces
. within 180 days o~ tlp\et~.&~~l"O)M~h~.. ~i '\l.VMt~.". . be c~mpleted (Certificate of Occupancy issued) within 18 m?nths o~ th~
Issuanccclate. C.I~S..~I.sg{}~"t!~. ," '. ,'_ )~.!i.;. g.\"c.l . .' ~IA1~imstratlveRulesoftheStateoflndiana(See675IAC12)regardmgexplratlOn
.,.,-, ' 'Qf:sta'S:Sr.i, ~~~.~b ". ',~," ~dcompletingconstruction. !
I, the undersigned, agree th.:;. t~ an _ ~.QfiSl=~ '~jt.' Qj~ ._ "~_.'_C o:.._:..,,,.._.~~ e.... ation, or alteration of a structure, or any change in the use of land ori.
structuresrequestedbyt0~JtiMTi, _ Y>E' .," _' 2[r@'__. ,: 'cable laws of the State of Indiana, and the "Zoning OrdinanceofCarm cl
Indiana -1993" (Z- ) . . " ~R - , '.. t oiity of r.C 36~7 et seq, General Assembly of the State of Indiana, and aU Acts amendatory
thereto. I furth r ti ._,.~'" itcb;ri~ b-~ttN0~ _ jUnf. are connected to the sanitary sewer. I further certify that the construction will not be
used or occ /' 1 Cer;iIicace of Occupancy !;aIbeen issued by the D VZ~ of ~~mu;!j::;;:::;:;mel, Indiana. /1 hit! (p
Signat ner or Authorized Agertt Print Date ,
~,.
.'
Base Inspections:
Cert. of Occupancy: