HomeMy WebLinkAbout06110029 Application
City of Carmel! Clay Township Permit #:A1t.J1f2D.4
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, 8< Two Family: New Structures, Additions, Remodels, 8< Accessory Structures
BUILDER
OF
RECORD:
NAME:
STREET ADDRESS:
()?F 1./ tl,'.te",- {<
PROPERTY
OWNER:
NAME:
STREET ADDRESS:
LOCATION
8< PROJECT
INFO:
LOT #: I SUBDIVISION NAME:
Ur
)'I.<'-,,;Cv....
ADDRESS OF CONSTRumON;
.j>yp, Cui...
Cr;< IA.J 0
SEWER UTILfTY
PROVIDER:
PHONE:
c?v 6- Yz FAX:
ou Y6 - 122 y
STATE: ZIP:
I 1/ V6z..yo
00 OF CONTACT:
- -I""-~
FAX:
STATE: ZIP:
SECTlONj ZONING:
CITY:
PHONE:
CITY:
',.
" .'/i
I' ,.
1i!'I!
Ii, ]"
ill Jli
ESTIMATED COST OF CONSTR
(EXCLUDING LAND VALUE)
I c__.~
L -I 4'"""-,------------/ ,~"I
t'r ~A'{_<J /
c.;;;'--'---J
PLUM~NG CONTRACTOR: o,/t/C/r' ~~".
6-'''-/ G, c~ @666, .,
Plum er's Indiana State Lie se #: 31',
WATER
PROVIDER:
SQUARE
FOOTAGE: 595;>-:
I\N:-7.a?'in- ) ""J
.u'"co c) .~!
\J .; II!
TYPE OF IMPROVEMENT:
c:vNEW STRUCTURE
o ROOM ADDITION(S)
o PORCH ADDmON(S)
o DECK ADDITION(S)
o REMODEL
_ Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION
Manufactured
Trusses:
Sump Pump:
~N
.:0 _N
NAME OF lITlLTTY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA I BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'5 (IF APPllCABlE):
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY:
TYPE OF CONSTRUCTION:
&'SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions. Remodels. Etc.)
PROJECT INFORMATION:
Early Release
Permit:
Lot Split:
_Y_N
_Y_N
TAX MAP PARCEL #:
/6r'1'o r
,
Which plumbing codes will be applied to the construction:
g..--rntemational Residential Code wI Indiana Amendments
o Uniform Plumbing Code wI Indiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area)
~RAWLSPACE 0 POST & BEAM PIER
o-SLAB Cl-'"1fASEMENT (WALKOLrr:_ Y L-ii)
For Single F~S6€Jlmf1l.~. . rm..rf~rJ,io,.iY-d!or acc~~sory structures, this permit is valid only if construction commences within 180
days of the dSi.RJ~eeb~~l)~j)din.,g P.:' ,~c1"rft~~l::f!oJ~N..pleted' (Certificate of Occupancy issued) within 18 months of the issuance date. Class I
structure permits ileSUbJ;;C.l..to'tB.~~:hlJtM)t({ (oG@a:datfofl)jtheStateoflndiana(See675 lAC 12) regarding expiration time frames for beginning and
." .~tate and Local Codes. completing construction.
I, the undersi~te~'M'iI'I\.;~S~\l."t~ent, relocation, or alteration of a structure, or any change in the use of land or structures
requested by ~IA~ 'I :oni.2!Y. wlrtf_ !.h~ ~o~~~able laws of the State of Indiana, and the "Zoning Ordinance of Cannel Indiana -1993" (Z-
289) and ame~eIrts~p tclbii~5fOW~P4nbAssembly of the State of Indiana, and all Acts amendatory thereto. I further certify that only
kitchen, bath, and floor drains ,are cO'fl~^~1flK sanitary sewer~YtuVther certify that the construction will not be used or occupied until a Certificate of
Occupancyhas been Issued by the t1el>'aftfii\!rllt.laf Community ServIces, Carmel, Indiana
~~~~ Jr.t. ~~oa~ //-!-d6
~natureofownerorAUthOrizedQ Print! Date
OFFICEUSEONLY:****************************************************~~*~L7*******************
INSPECTIONS REQUIRED: Filing Fees: 7t1(- "j
.- . . Base Inspections: ;:;; -;l1 <; {)
Upper Footing Lower Footing U der.S1ab ~ -0
Cert. of Occupancy: .5:> 3 :>
P.R.I.F.: ,/ /IJ-r:;/ () 0 Additional Fees
C26~tO, TAL:,,?',? . ..$ dJ '7~. SO'
/~//}' .//~::
01::~I::::1;:_</:;;/ '-------
~'\ieWed/AP'P ved: ~ept. of Community Services
'I11itsjForms{IlP RESIDENTIAL
,
(Date)
Fee Received by:
# Charged Re.
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