HomeMy WebLinkAbout06110058 Application
City of Carmel/Clay Township Permit #: Oft; I /tJ1J f3 y'
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For.!,ingle Family, Town Home, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
STREET ADDRESS:
'7 II ~ YUhb
~~f;~N 'V 1. ..~.c::~_=_==~_n~S'-ON:
CAYM-V \ r0 t03~~-~:-~:'~.~._~~_: ".
SEWER lITILITY WATER lITILITY III' '1 E~~lJ'D COST <)foc;,O,tJSTRlJ(inON:
PROVIDER: '( mu... I PROVIDER:CA (MQ.\ Un lAtl€fl, II (EXfiIlJtYIN~ ~D ~6iJIJ) t~ ,000
NAME OF lITILITY EXCAVATION CONTRAcrOR; PLAN COMMISSIDN / BZA / BPW DOCKET jlJ 'SL___..__ ! L,. !
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'5 (IF APPUCABIX): _~~_'_nJ i
I .
FLOOD ZONE AREA DESIGNATION(S) ~ L TA)(-MAPPARCEL.#: ',-=1-'09 2J1.0 I 0 107/- DO
FOR THIS PROPERTY: 1\ I 1
BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
&. PROJECT
INFO:
~~ ~INGtrt1AN
mlEET ADDRESS: () l
/II et..nntbt' ~
lo\7~ ,Nf,+
TYP OF CONSTRUCTI N:
TYPE OF IMPROVEMENT:
SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
/ time:
f!iI RESIDENTIAL (For
Additions. Remodels. Etc.)
o NEW STRUCTURE
~ ROOM ADDITION(S)
o PORCH A.DDITION(S)
o DECK ADDmON(S)
o REMODEL
_ Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
PROJECT INFORMATIO.t!: / 0 DEMOLITION
Early Release ./" Manufactured / .
Permit: _Y -=--N /rusSes: ...!L:...Y _N
Lot Split: _Y ~ Sump Pump: _Y _N
~~~7b (p
FAX:
STATE:
I'"
BEST METHOD OF CONTACT:
&.It- 0Z..CS-W2.2-
0JJ:~7?J70~
Cft/~
ZIP:
CA(~
2-
FAX:
I~ATE:
ZIP:
SQUARE
FOOTAGE:
'240
,
PLUMBING CONTRACTOR:
_RotJ~\d 0h\(~ ~
Plumber's Indiana State License #:
~C- \C,-\ oao '-\ \.,
Which plumbing codes will be applied to the construction:
o International Residential Code wI Indiana Amendments
~ Uniform Plumbing Code wfIndiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area)
o CRAWLSPACE 0 POST & BEAM PIER
rs;/ SLAB 0 BASEMENT (WALKOUT:_ Y =N )
For Single Family and TWQ Family dwellings, additions, remodels, and/or 'accessory structures, this permit is valid only if construction commences within 180
days of th~e 0 . sfje of the bUildinamenni,t. and must be completed (Certificate 01 Occupancy i"ued) witbin 18 montb, 01 the '"nance date. ClaM I
structure .. . . Rules of the State of Indiana (See 675 lAC 12) regarding expiration time frames for beginning and
completing construction.
I. the undmigni:d. ag'" mno . ct. nJargement, relocation, De alteeation 01 a >tructute. De any change in the use of bnd Ot >tructure,
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 LC. 36,7 et seq, General Assembly of the State of Indiana, and all Acts amendatory thereto. I further certify that 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
Occupancyhas been issued by the Department of Conununity Services, Cannel, Indiana.
()rU\~ ~"^j("\~0
Print
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OFFICEUSEONLY:******************************~~********************J;******i)*******************
INSPECTIONS REQUIRED: _ Filing Fees: tail. ~
Gpp~r FO~ Lower Footing Under SI~ - Base Inspections: ~ -; ,.,77 ~ de)
___ >- Cert of Occupancy: :;- r ~O
QOU9h V Meter Base Final Site
P.R.I.F.:
I
CV"lL-.~H /.s'~ L1-I5"'- ?YS'
Reviewed/Approve!d: Dept of Community Services (Date)
0/'(/;;6
Date' I
# Charged Re~
Reviews
S:Permlts/Forms!IlP RESIDENTIAL