HomeMy WebLinkAbout06120049 Application
City of Carmel/Clay Township I permit#~
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, 8r. Two Family: New Structures, Additions, Remodels, 8r. Accessory Struct~res
.,
BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
8r. PROJECT
INFO:
SEWER UTILITY
PROVIDER:
NAME:
FAX:
CITY:
lieu) lYe.J-An€.
ZIP:
611, 3
STREET ADDRESS:
,g..39 S_ Carrie J)r
BUILDER'S EMAIL ADDRESS:
STATE:
JA/
BEST METHOD OF CONTACT:
ceJ h -51 ~- tJ5~
UJ;lJe-v-
PHONE: .
'317 515 - cJ5/9
FAX:
6a.# - call i5f-
fre.J.. &1 a es e/
ADDRESS OF CONSTRUCTlON:
i 5 iJo.Jckn
LOT#:
/03
'J..Jde~ PL
SUBDIVISION NAME:
Ede Esfo.le.s
CITY:
'ann e./
ZIP:
~ 033
STATE:
:rN
SECTION:
3
ZONING:
WATER UTlUTY
PROVIDER:
SQUARE ~
FOOTAGE:
ESTIMATED COST OF CONSTRUCTioN --.-J: o=u
(EXCLUDING LAND VALUE) /i,/ /l ~~p(.f?~~-...
J / ,-..../ --- '<~..rl I C'-0 -'-.
11If1}! ~<I-'-"c? 17 f'~'"
III ........;::::.. ~ ,G/' ,,'":.:,.'--
f II ~I/ 1,->,_-
NAME OF UTILITY EXCAVATION CONTRACTOR; PlAN COMMISSION 1 BZA 1 BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNlY WELL AND/OR SEPTIC PERMIT #'S (IF APPUCABLE):
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY:
TYPE OF IMPROVEMENT:
o NEW STRUCTURE
o ROOM ADDITION(S)
o PORCH ADDmON(S)
o DECK ADDITION(S)
j:& REMODEL r. ICU::L
_ Basement InIS onlV
o ACCESSORY BUILDING 0 International Residential Code wflndiana Amendments
o DETACHED GARAGE .. .
o ATTACHED GARAGE 0 UnIform Plumbing Code wflnd,ana Amendments
o DEMOLITION/.f W~,.uJ/ I
I1lQ.Q-, I IJliJJ l ,;mJNDATION TYPE: (Check all that apply for the ne,w
Manufactured. construction area) I
:~:;'~UCi\O~~ ~ ~::LS:C:ASE~N;~::OlfT: BEA: _P~~R
UI"'C \1 , lOOB
For Single F~_ ", ": - ftiIx.d~WIn~:Nt pdels, and/or accessory structures, this permit is valid only if construction commences within 180
,days otthe daf \AA~MH~I& .1f\~~t, ~Sted (Certificate of Occupancy issued) within 18 months of the issuance date. Class I
structure pennie!ubje~~~ e{-a1.A.dnJitmlr:Sm,~Js 0 ate of Indiana (See 675 lAC 12) regarding expiration time frames for beginning and
. 0,1" COMNlU''': ',,'y -rOW ingconstruction.
I, the UnderSigned=:e.Fibt t.c~~, te6~tibn, enlargement, relocation, or alteration of a structure, or any change in the use of land or structures
requested by this a . ilf"l"Fl~~<\nRh.,,1J{orm to, all applicable laws of the State of Indiana, and the "Zoning Ordinance of carmel Indiana~93" (Z~
-;""'<e!, , 289) and dm .._ a oj3'rea under autl\~~f1.,~~'7 et seq, General Assembly of the State of Indiana, and all Asts,an-1eIlClatory thereto. I further certify that only
'b:~'~':c f.'kitch~n at, nd floor dra' ar onnected to the sanitary sewer. I further certify that the construction will of be used or occupied unt, il a Certifica. :;2e of
';:~,J': :~ Oced e Department of Community Services, Cannel, Indiana. I' I;) 0
"W .}
-- red- &Ia.e~ V / / '/eJ. -/,,;J ~O(,
Print D~
TYPE OF CONSTRUCTION:
o SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
~ RESIDENTIAL (For
Additions. Remodels. Etc.)
PROJECT INFORMATION:
'Early Release
Permit:
Lot Split:
_v ,j N
_VLN
TAX MAP PARCEL,~fJ L1j 'EC 1 "~:.,;' !:. ;
/ '--....... J /// ,'/
PLUMBING CONTRACTbR:~~"~, VQ ;///1' I. ' If
~ /lUll
~/<" I
Plumber's Indiana State License #: ~"-...
"--
p umbing codes will be applied to the construction:
OFFICE USE ONLY: *******************************.~***********************~****~O*****************
INSPECTIONS REQUIRED: FIling Fees: /33 ,)
_ . Base Inspections: / / / - t1 0
Upper Footmg Lower Footmg Under Slab ,"
Cert of Occupancy: 57. S-I/
~ Meter Base
# Charged Re-
ReViews
~
Site
Additional Fees
P,R,LF,:
1'2-/4-
Dept. of Community SelVices (Date)
S:PermitsJFormsJILP RESIDENTIAL