HomeMy WebLinkAbout06110097 Application
City ofCarmeI/Clay Township Permit #: DCR, 1\ 0011
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER of NAMEf3 11- PHONE r (' F~ '
RECORD: EflZEIC DMt-'5 5 l.H353 If' 7t'J7 Y
~Err ADAlS SIc ct-o cm STATE ZIP
',;/1J:fl . MEI<I blllli 7;JIJPL5 .ZJ S7t,2 (,0
BUILDER'S EMAIl AtDRESS . BEST METHOD OF CONTACT:
fmerrl + @J beaLer. corn
PROPERTY N,6 HOMES PHONE y' FAX .
OWNER: l:..frZE f!. 5&9-353 . Plr?- 707Y
~REET ADDA/. Men d/ol) S-k 300 cm STATE ZIP .
';{ 0,2 - ;;; D/'{ 5 IN n.:z~o
LOCATION LOT # SUBDIVISION NAME WE'5TCU~ .; SEmON ZONING: 5 1
& PROJECT 1071 V/LUjCE OF &00/ ~~
INFO: ADDRESS O~ONSTR~ON SQUARE "'/ < /'
I J7 9 ot:syrf/ 5T.eEET FOOTAGE:
SEWER lITILITY e,K volb I WATER UllLl1Y ESTIMATED COST OF CONSTRUcnON:
PROVIDER: PROVIDER C Ii 1?. M E{ (EXCLUDING LAND VALUE) 1?;25:5D
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION I BZA / BPW DOCKET ~I L.i3ci. e-/11e liU~
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE): 19(,11 0 10 I
PLUMBING CONTRACTOR: '1','",-
EAf?.L (;'t:.f-fl/'
Plumber's Indiana State License #:
1{)5 Ii CJ1
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT:
o SINGLE FAMILY bTJ~ - '#- ~ NEW STRUCTURE
~ TOWN HOME 1!J .1' (jl>(J~~ ,... 0 ROOM ADDITION(S)
b TWO FAMILY , \ ~-dl- 0 PORCH ADDITION(S)
# of units: -\I\~ 0 REMODEL
o MULTI-FAMILY 0 ACCESSORY BUILDING
# of Units: 0 DETACHED GARAGE
o -RESIDENTIAL (For 0 ATTACHED GARAGE
Additions, Remodels, Etc.) 0 DEMOLITION
Which plumbing codes will be applied to the construction:
o International Residential Code w IIndiana Amendments
o Uniform Plumbing Code wI Indiana Amendments
(MUlti-Family Construction Code)
PROJECT INFORMATION:
Early Release
Permit:
Y /N
y7N
FOUNDATION TYPE: (Check all that apply for the new
construction area)
Lot Split:
Does any part of the prop
o CRAWLSPACE
o POST & BEAM
o BASEMENT
WALKOUT:_Y_N
For Single Family ang~ -~a~~'~AJ "~ Ci ~i ~l. odds, and/or accessory structures, this permit is valid only if construction comr:nences
.. within 180 d~~ ~~'e'" ,~~u~n~ permit, and must be completed (Certificate of Occupancy issued) within 18 months of the
.l. issuance date. p at~~YmRA _ SP~.to the General Administrative Rules of the State of Indiana (See 675 lAC 12) regarding expiration
~ )\ , ~~ ',' ;.:...~ C; ~\.. \. "ames for beginning and completing construction.
. I,:the undersigned, agree_~ ~ 5.os...~tlc, nstruction, enlargement, relocation, or alteration of a structure, or any change in the use of land or
structures requested ~~ a~~n w' ply with, and conform to, all applicable laws of the State of Indiana, and the "Zoning Ordinance of Carmel
Indiana - 199r (Z~ 28~~a~bdments, adopted under authority of I.c. 36~7 et seq, General Assembly of the State of Indiana, and all Acts amendatory
. thereto. I further cert6\~at only kitchen, bath, and floor drains are connected to the sanitary sewer. I further certify that the construction will not be
,'~~ ,. used or cupied untlla Certificate a/Occupancy has been issued by the Department of Community Services, Carmel, Indiana.
;'t . Ii ~, - $arzaJIo/11l"tlA M Et-lJry -l3fflzriJ.. !toMI:S !f./'-/ or~
. Signature of Owner or Authorized Agent Print Date
OFFICE USE ONLY: **********************~~*************************
(/ Filing Fees: .
INSPECTIONS REQUIRED: U\11Base Inspections: Z 7 ,60
Lower Footing K .-:2_ e.,-O
Cert. of Occupancy: oJ.:2::- ~
P.R.I.F.: / ~f ' [) 0
~~Z?7/.
***************
# Charged Re-
Reviews
Site
Additional Fees
10