HomeMy WebLinkAbout06110072 Application
City of Carmel I Clay Township Permit #~
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
&. PROJECT
INFO:
NAM :
'fL-r {)J
~73;7
fc.HM t\lJ~~
FAX:
7 S7{--L'-/f.:,
STATE: ZIP:
cI6 Z56
CITY:
UfjlJ C7: 7JV()!<-f .
BUILDER'S EMAIL ADDRESS:
~~W.JC 111
NA~
STREET ADDRESS:
~
L~
LOT#:
trJ'L
~ SUBDIVISION NAME:
V fL.L~E OF '-<l6J1C-
ADDRESS OF CONSTRUCTION:
JD 7 "! r; jJ ClfLe:t,;
SEWERlJTILITY ~ yc.uO
~. ~r-e
PROVIOER:
-.PG
WATER UTILITY
PROVIOER: ~L-
BEST METHOD OF cO.NTfer:
sf C/L/J'-Z/9r
~
PHONE:
2-9i-t,2..b3
FAX:
CITY:
STATE:
liP:
SECTION:
ZQN G:
J tJbUT~
SQUARE
FOOTAGE: 70 2...3 J
E5nMATED COST OF CONSTRUCTION:
(EXCLUOING LANO VALUE) 7 Lr. 000
#='06//007/
G~bLIE &LA-1IA-7/NC;.
NAME OF lITILllY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WEL~.A~tiiQ~ SEPTIC PERMIT #'S (IF APPLICABLE):
/ '" "'-'.'..
o
Early Release
Permit:
Lot Split:
~V ./ N
~VVN
Manufactured
Trusses:
Sump Pump:
V ./N
/V=N
TAX MAP PARCEL #:
PLUMBING CONTRACTOR:
Sq/v8Lc<:L PUJM6rNb.
Plumber's Indiana State License #:
c.P)J/n (5 5G",C
Which plumbing codes will be applied to the construction:
~Intemational Residential Code w/Indiana Amendments
o Uniform Plumbing Code wI Indiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area)
B" CRAWLSPACE 0 POST & BEAM PIER
o SLAB ~ASEMENT (WALKOlfT:~V /N)
For Single Family and TWllJi&'!>,\li'~5iAYeT ory structures, this permit is valid only if construction commences within 180
days of the date of issu~ Wll~!9:.o n~~ificate of Occupancy issued) within 18 months of the issuance date. Class I
structure permits are su~_b[EIut llHlM!ft.Ira e~it"e'~t~t~ ~f I~diana (See 675 IAC 12) regarding expiration time frames for beginning and
", " of Slate and l.O~a. O_pI51illll.'iIlI"truction.
I, the undersigned, agree t~,~at,~ an" CJ2P, ~~' '" l~~'t;;t:;&'m~\or alteration of a structure, or any change in the use of land or structur~s
requested by this applicatioiJ,>>1;11~:In~ lNi , ,J~~dit IState of Indiana, and the ~Zoning Ordinance of Cannel Indiana - 1993" (Z~
289) and amendments, ad' '.' :-I_~JPe~EW, e ~~f~ftlie State of Indiana, and all Acts amendatory thereto. I further certify that only
kitc ,bath,and floord' r c~decte~ t~ th;'; " . r. I funhercertify that~the construction will not be used or occupied until a Certificateo!
('E' "pancy n i"ue by the Dep servicet:::-~Ind';). .r~#f;/\ ~ {I II.J 10 I:.
Signature of Owner OJ" Authorized Agent Print Date I
OFFICE USE ONLY: ****************************************************** ***************************
NSPECTIONS REQUIRED: Filing Fees: .I (} r/. ~ V
Upper Footi - ~er Footi~Under Slab_ Base Inspections: d "/1, ~ ! J
~ ) Cert. of Occupancy: 5...3. :, (.
C ROU9h~ ~ter Ba~') inal Site) ,/,)-' Go /, Cf (J
_ ~ P.R.I.F.: ~
# Charged Re-
Reviews
Addibonal Fees
1/-
ept. of Community Services (Date)