HomeMy WebLinkAbout06110129 Application
BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
& PROJECT
INFO:
\ 13%JI./ t4J::TJ() avc/-lJSUr<C
City of Carmel I Cz~; Township Permit #: () W '10 to
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
NAME: PHONE:
L .:r: S/au€, a.. .D.J~ ,I.,S'
FAX:
STREET ADDRESS: CITY:
<11t:X> N. J~AlG- bE ktAA/Jc:.IE
STATE:
ZIP:
'-f 730'1
BUILDER'S EMAIL ADDRESS:
BEST METHOD OF CONTACT:
NAME:
~ #'fi/b/llI<'A owAl
STREET ADDRESS:
~fl HoLUW 6/t-J:::-UZAIL-
PHONE:
t;~ 3 4~Y),
c~R-.
FAX:
STATE:
.j:}J
~D3:3
ZONING:
s-
SECTlON:
:2.3
SUBDIVISION NAME:
SQUARE I
FOOTAGE:
SEWER UTILITY ESTIMATED COST OF CONSTRUCTION:
PROVIDER: (EXCLUDING LAND VALUE) ~
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / aZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'5 (IF APPLICABLE): ~!V E!
;2,()rz~ X
TAX MAP PARCEL #:
FLOOD ZONE AREADESI.<:iNATION(S)
FOR THIS PROPER~
'l
TYPE OF CONSTRUcnON: J. TYPE OF IMPROVEMENT: PLUMBINGCON RACTOR:
I!!f'SINGLEFAMILY tJl/la;J.. t~~EFOR CO~STP,UCT~
o TOWN HOME I.q,p,t j ~ganceW'thjlj~ifiiJe,PS,I,nd,ia,naStateLicense#:
o TWO FAM~LY. l~ ()' \11l- . (~d Local Codes
# ofun.tsbe.ng ,,,0 0 DECKAD UNIT"SCn''''':cc;
constructed at this v .10 0 RPMn1:mOF C M T. '.' .. .
time: l'! J/..;. ,r.: ~~"r- .. nl CLA"~~~~'Rdes will be applied to the construction:
o RESIDENTIAL (For 0 0 ~~Ir~ ';ANA '0 International Residential Code w/Indiana Amendments
Additions, Remodels. Etc.) A.. 0 DETACHED'G';.~;~'tl1
C Y l'o ATTACHED GARAGE 0 Uniform Plumbing Code w/Indiana Amendments
PROJECT INFORMATION: tpf,"):J DEMOLITION FOUNDATION TYPE: (Check all that apply for the new
\fI _ construction area) t~"...<tollJ<:)
Early Release y, Manufactured 1 \/,
Permit: _Y -I-N Trusses: _Y N 0 CRAWLSPACE ~POST&~BEAM_PIER
Lot Split: _Y -$N Sump Pump: _Y N 0 SLAB 0 BASEMENT (WALKOUT:_Y_N)
:s
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this peririit is falid oiilyJ!cC91~t~tion commences_'~'!thip 180
days of the date of issuance of the building pennit, and must be completed (Certificate of Occupancy issued) ktlilii 18 m~ftAs ~,f-the'fssu.aitce~_ate.-_~1iSs I
structure permits are subject to the General Administrative Rules of the State of Indiana (See 675 lAC 12) regal~lirig e3cpirationtiine:~Ji~r'"begirining ~d
completing construction. : i iJ II -.-..-j ) Ii: ,
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alteration of a structure! pr~Ylchange in the use of land or stru~,tpre~ II
requested by this application will comply with, and conform to, all applicable laws of the State of Indiana, and the "Zohing ordi:tt!2~f~'~e1~na - 1993" (Zr
t t) J I I.IL I 'I
289) and amendments, adopted underauthonty 0 LC,-JG..7~~'l: General Assembly of the State of Indiana, and all ~~ts amenda ory he t If RR certIfY. thin only
kitchen, bath, and floor dr<3.ms are connect 0 the samtary sewe2'1 rther certIfy that the construction will not De ~~ed or occupied until a Certifjca'r~lov.1
Occupancyh"be D'" by the 0 '"'tmeDtof/Olnrn~nitysem s,Carrnel,Indim, L L-~---il t~1k
int Date --J
OFFICE USE ONLY: ***************~
_INSPECTIONS REQUIRED:
cUP~r Fnntin~ Lower Footing Under Slab
~ Meter Base ~ ~
/j/J1~ fIJtf
Reviewed/Approved: Dept. of Community Services .(Date)
S;PermitsjFormsjILP RESIDENTIAL
**********************************~**?f*******************
Filing Fees: /5'") , '5
/ in ~,)"O
">3. )'c1
Base Inspections:
Cert. of Occupancy:
# Charged Re-
Reviews
P.R.LF.: Addiuonal Fees
(',#/ T,,6T,A,t:f/j7 jI-,/): 3-;/
"-.----? '/l-;V "(' If J I
/ t:.-. ,cr'-'r A // (~~
Fee Received by: ,,-
Date