HomeMy WebLinkAbout06110094 Application
City of Carmel/Clay Township Permit #: Olol\ O'O~
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
BUILDER of
RECORD:
PROPERTY
OWNER:
LOCATION
& PROJECT
INFO:
NAME f) PHONE
fFcF' \D 5(,,9- 353~
STREET ADORE,55 <i . CITY _~1E
9.;2D;2 Al /"1E/liJ:JIf'iN vrc- 3oo:TND,ls 1/v
LOT # I SU~ !VISION NAME i. I /1 J ./
ID 7'-1 " AGE of YVE"5r It..lIy
NAME
-L f: {( (-Ie, M F5
fl-I DIIlA/ Sir 30v
E"
~EET ADDRESS
'-f.;lD2 A.I
BUILDER'S EMAIl ADDRESS
tm c\- -j ++ @ be.e;"Z-e 1-. CO /Y1
Srf?,~T
SEWER UTILITY
PROVIDER: C. T f( Vv
WATER UTILITY
PROVIDER: I A R/v1 E i...
PHONE .
6CcC; <353!
CITY
LNQ_b
F~/;P707
STATE
.T:j
ZIP
t./ ".;2 t." 0
BEST METHOD OF CONTACT:
FAX
;;/J' 7D 7
ZIP
c; ",;u" 0
SECTION
weel
ZONING: 5
SQUARE
FOOTAGE:
ESTIMATED COST OF CONSTRumON: / C"/1 j ~
(EXCLUDING LAND VALUE) () 0' (p~U
~
00 ~
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION I BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'5 (IF APPLICABLE):
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT:
o SINGLE FAMILY .~. /1J\~ NEW STRUCTURE
~ TOWN HOME jf!> .1' ~c:; ROOM ADDITION(S)
o TWO FAMILY ,,1~~~"1 0 PORCH ADDITION(S)
# of Units: /< 0 REMODEL
o MULTI-FAMILY 0 ACCESSORY BUILDING
# of Units: 0 DETACHED GARAGE
o RESIDENTIAL (For 0 ATTACHED GARAGE
Additions, Remodels, Etc.) 0 DEMOLITION
PROJECT INFORMATION:
Early Release
Permit:
Lot Split:
_yLN
_YLN
Does any part of the property
PLUMBING CONTRACTOR:
EA~ Gr..Jl'{ 't SD~ c::.
Plumber's Indiana State License #:
) 05 C/O?
Which plumbing codes will be applied to the constl'"uction:
o International Residential Code wjIndiana Amendments
~ Unifonn Plumbing Code wjIndiana Amendments
(Multi-Family Construction Code)
(Check all that apply for the new
_Y /N
o POST & BEAM
o BASEMENT
WALKOUT:_Y_N
For Single Family and Two Fami ~~s acl.~~~r~~~;4~ ~ctures, this permit is valid only if construction commences
; within 180 days of the date of issua?ce of t~ 1;WiJ6~!nnr",ol,Jtd~s~' c~mpleted (Certificate of Oc~upancy issued) within 18 m~nths o~ th~
,- !ssuance date. J:lass I structure rerITIlt~~rctY2..."'ij1~.r~}!iI;;';inJstratlve Ru~es of the Stat~ of IndIana (See 675 lAC 12) regardmg expIratIOn
'. .-'Of-f) dI61k\n)ll~:r~~g and co~pletmg constructIon. .
I, the underSIgned, agree ~hat any c~IYK1\~oQkcon~truct~HJargement, relo~anon, or alteration of a structure, or any c~ange_ m the ~se Df land or
structures requested by thIS apphcatlO"""'-'ill comply '\V1th, and conform to, all applrcable laws of the State of Indiana, and the Zonmg Ordmance of Carmel
Indiana - 1993n (Z- 289) and amendments, adopted under authority of LC. 36~7 et seq, General Assembly Df the State of Indiana, and all Acts amendatory
thereto. I further certify that Dnly kitchen, bath, and floor drains are connected to the sanitary sewer, I further certify that the construction will not be
used I occupied until a c:.ertiB ce of Occupancy has been issued by the Department of Community Services, Carmel. Indiana.
~-fl 'lr:.... . IIA fv!t:Uill ~PCI1Z[~ ~0 1{}<-/cJ~
Signature of Owner or Authol'"ized Agent Print Date
OFFICEUSEONLY:************************************************************************
e; Filing Fees: t, Z q , '70
INSPECTIONS REQUIRED: ~ /) t1M ""'0
'A\1i Base Inspections: '^ L I' ---.l # Charged Re-
c!!pper ~uul~ Lower Footing VI 11:" ~ ~ 0 ReViews
~ Cert. of Occupancy::- 0":";, <...J
CR~Meter~ Final Site [I.R.LF.: / ;Z~I ' 00 Additional Fees
~('~V'4...;() l-ti5.-R-/ 11-7,!-ob /)iJ..'J...?L,10
,,,,edIApproved: Dept. of Community Services (Date) ~
cs/Forms/llP RESIDENTIAL Fee Received by: