HomeMy WebLinkAbout06110104 Application
City of Carmel/Clay Township Permit #:6t,/ I Olo+-
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER of
RECORD:
/ STATE
't
ZIP
/err40.
f
FAX
S8d-C).4S3
PROPERTY
OWNER:
PHONE
FAX
STREET ADDRESS
cm
STATE
ZIP
LOCATION
&. PROJECT
INFO:
SUBDIVISION NAME) - ) h .
0<-' YlCo trJ -S ,;{!. r::-
ADDRESS OF CONSTRumm~ ./)
Ji/;)75 t:j/l/OW Kun
CIa
WATER UTILITY
PROVIDER:
t:l~/Y7e/
,
ESTIMATED COST OF CONSTRUCTION: '18 / 1
(EXCLUDING LAND VALUE) D<' <.9 00
LOHr:)5
SEmON /
ZONIN0 _ / ~
SQUARE / . 00
FOOTAGE:<..90 /1
SEWER UTILITY
PROVIDER:
TYPE OF CONSTRUCTION:
I'j!! SINGLE FAMILY
tJ TOWN HOME
o TWO FAMILY
# of units:
o MULTI-FAMILY
# of Units:
o RESIDENTIAL (For
Additions, Remodels, Etc.)
TYPE OF IMPROVEMENT:
(5iJ NEW STRUCTURE
o ROOM ADDITION(S)
o PORCH ADDITION(S)
.0 REMODEL,
o ACCESSORY BUILDING
o DETACHED_GARAGE
.0 APrACHED'GARAGE
. -.... . '" ,
D. DEM0LITION
PROJECT INFORMATION "Iii;, ' '" .. .","
: "",._:1""'"
Early Release "":Manufactu'..ed',,, . _. FOUNDATION TYPE: (Check all that apply for the new
Permit: ~y ~N r~"fhJsse1.:d"'.'_~''''''j.'\~Y:,,~N construction area)
Lot Split: _Y 1!-N ; >l~~~i~IJ~;"tr~~~~N B ~::::LSPACE ~ ~~M&E~~M , j
Does any part of the P"'i'P!;~!i1~~~Ri~1 I' :~IJ-;",J. "'~~ designation area: _ Y $N WALKOlfT:_ Y ~N
For Single Fam!l>:,a.u~ ~ .T31j , \ .i ; '".'>" '~;' and/or accessory structures, this permit is valid only if construction commences
within 180 ~pn~ii: ,0 .. " --" '~'t::-ii'nd must be completed (Certificate of Occupancy issued) within 18 months of the
issuance dat~:,~~rJt ". ~,:~.n:'inistrative Ru~es of the State of Indiana (See 675 lAC 12) regarding expiration
,'. . "~~OSFS~~. mg and completmg construction.
I~ the undersign~~~a ent, relocation, or alteration of a structure, or any change in the use of land or
. smtcrures reque~yth~D .' ". , n conform to, all applicable laws of the State of Indiana, and the ~Zoning Ordinance of Carmel
~~'Indiana -1993~~~.:'r...:'o}~. , f)\under authonty of I C 36~7 et seq General Assembly of the State of IndIana, and all Acts amendatory
't thereto. I furth~~~r[ify that oill)ddt , and floor drams are connected tO~he s tary sewer I further certIfy that the constructIon will not be
'.,use occupIed until a rtIficate of Occupancy has been Issued by the epartm t f CommunIty Servl1es, Carmel, Indiana
. nn. ~ bel' //-/7 -o(P
(1) /C, ~t.jj- ::q: 00 110 103
PLUMBING CONT~CTOR: /
L.)) /f)hcvn,cCL_
Plumbe?J Indiana State License #: , '
::t!C 8/0 (o4sL/O
NAME OF UTlLI1Y EXCAVATI N CONTRACTOR; PLAN COMMISSION / BZA I BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'5 (IF APPLICABLE):
Which plumbing codes will be applied to the construction:
~ International Residential Code wI Indiana Amendments
o Uniform Plumbing Code w/Indiana Amendments
(Multi-Family Construction Code)
..~::"
'-..~~."
.:.;:~
Print
Date
c ~ J.
~ ReviewedjAppr ed: Dept. of Community Services
~ "-.... S'P"m'''/Fo~~lLP RESIDENTIAL
***************************~~~*~yj***************
Filing Fees: Y Yr. Ii
c21? Yc)
Cert. of Occupancy: 53.YtJ
/ I 6/ '/I)
P.R.I.F.: /.7" I" I~ (./ , Additional Fees
L_~:;:I~/,- ~TAL~ -:'/.7/,,/ :;]'/:7;7{2(j(J
~/ ~r A .:.://c ( v
{/{.~/:.-c...-r-" ~~'----..
OF
Base Inspections:
# Charged Re-
Reviews
Fee Received by: