HomeMy WebLinkAbout06110096 Application
City of Carmel/Clay Township Permit #: <ou'11 ro'llo
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER of
RECORD:
~EET ADDRESj
'Ic:{D:< AI.
HOMES
/V!CI!i/)/fJA,5IF ..300
CITY
X>J bPi:',
FAX
,flY 707
ZIP
'-/1,.,2 ~ 0
STATE.
;:L;./
BUILDER'S EMAIL ADDRESS
fnJe.-r,H @ DeQ<..cr. CO"l
BEST METHOD OF CONTACT:
PROPERTY
OWNER:
PHONE
A ES 6/.:/1- 3~ 3 <I
CJ;.EIT ADDRESS /VICR/D/4N CITY STATE
~02 AI ~/t>Pl5 :TAl
LOT # SUBDIVISION NAME WEST t.LA. SECTlON
107(, LlAGE5 OF &00/
FAX
?/?, '?07L
ZIP
c.;C2.&O
LOCATION
&. PROJECT
INFO:
ADDRESS OF CONSTRUCTION
1rJ,'7'-/3 FDR'5Vnl S'Tf(EET
ZONING:
5/
SQUARE 1,3 <c
FOOTAGE:d-3 Jar
SEWER UTILITY /I
PROVIOER: L/;( 11/6
WATER UTILITY
PROVIOER: ell R. "''I f l
ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING LANa VALUE) /53 cOO
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION I BZA / BPW DOCKET I ... ,~
NUMBERS; TAC DATE(S); AND/OR COUNn' WELL AND/OR SEPTIC PERMIT #'5 (IF APPLICABLE): ~~ L , :2....~~,..,.. V
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT: PLUMBING CONTRACTOR:
o SINGLE FAMILY p(l ",(t~ NEW STRUCTURE € /I J'..L C' f<.A y' f SDNS
~ TOWN HOME :pfyl> J- c,.\or". ~6 ROOM ADDITION(S) Plumber's Indiana State License #:
TWO FAMILY \ Wi~""'" 0 PORCH ADDITION(S) /0 6 c7' /'0
# of units: U 0 REMODEL - -~
o MULTI-FAMILY 0 ACCESSORY BUILDING
# of Units: 0 DETACHED GARAGE
o RESIDENTIAL (For 0 ATTACHED GARAGE
Additions, Remodels, Etc.) 0 DEMOLITION
,?ILII 0 100
Which plumbing codes will be applied to the construction:
o International Residential Code w{Indiana Amendments
o Uniform Plumbing Code wI Indiana Amendments
(Multi-Family Construction Code)
~t
~ Manufactured FOUNDATION TYPE: (Check all that apply for the new
./ construction area)
_Y _N Trusses: Y N
_yo /N ---;; - 0 CRAWLSPACE 0 POST & BEAM
Lot Split: . v N Sump Pump: ;rao\t--N ~ SLAB 0 BASEMENT
Does any part of the property lie within ~ W)i 8fl\flesignation area: _Y /N WALKOUT:_Y_N
For Single Family and Two FarWJ.~i s~~tQ\ht~ models, ~d/or accessory structures, this permit is valid only if construction commences
'." ~thin 180 days of 1he.c!-t\ett~~f\~~,~t'"\i0 !t~.~'l\.1 . .~~st be completed (Certificate of Occupancy issued) within 18 months of the
.'- issuance da~e. Cla~~.~cl WO gt)\ffi{.. :. ~\'\." ~~f!'l:..;Qf. t!s~li:1. ..~ , ~strative Ru~es of the $tat~ of Indiana (See 675 lAC 12) regarding expiration
S\J'o\eG\ ~ S\3:~;~tA~~~l"r~.nJCott .ng and completmg constructIon.
I, the undersigned, agree that aID ~~~, ri(~.tidri, enlargement, relocution, or alteration of a structure, or any change in the use of land or
structures requested bY1bi.., ~~oEd'.uft..~ .t, and conform to, all applicable laws of the State of Indiana, and the "Zoning Ordinance of Carmel
Indiana - 1993" (Z~ 289pQ a~6P~,..~1t~' urhority of I.c. 36~7 et seq, General Assembly of the State of Indiana, and all Acts amendatory
thereto. I further certiP,t~ cMij kitchen, b}l\lf'(n"d floor drains are connected to the sanitary sewer. I further certify that the construction will not be
used or occupied untlt'.l Certificate of Occupancy has been issued by the Department of Community Services, Carmel, Indiana.
~~iJ E /lIE/.. MwcY IiA /1 aUrf - &71Za !Jc,ME5
PROJECT INFORMATION:
Early Release
Permit:
//1</0,"
Signature of OWner or Authorized Agent
Print
Date
# Charged Re-
Reviews
Site
P.R.I.F.:
/
Additional Fees
cJ.....'
Reviewed/Appro d: Dept. of Community Services
S:Permits/forms/ILP RESIDENTIAL
,~o
Fee Received by: