HomeMy WebLinkAbout06120056 Application
~ . . CALL A-1 EXPEDITORS . ObI/) ooC;(-
CIty of Carmel/Clay Townshtp 695-~1i'S<:O ~Permlt #: dI 'f/
RESIDENTIAL IMPROVEMEN'ff?~~NliPiER.MIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
NAME:
,UILDER
OF
RECORD:
ojtj 65
OA.fU~
PHONE:
/ flU? GI'9l:'
FAX:
3/7 .or <5'!?y
CITY:
J.. N() I\J (.>t.S ..
STATE:
IJ,)
ZIP:
'1'2-80
BUILDER'S EMAIL ADDRESS: BEST METHOD OF CONTACT:
.:rS R \~ I-ey @ O~v~(.'jtlC Ut:o"E5 . c..-c.',-1
CITY:
WI/VIt/t!rI{5 c-, " E
SUBDIVISION NAME:
S {lDDL':;: /3(2.00 (<
PROPERTY
OWNER:
NAME:
.s r: Co-
STREET ADDRESS:
1'2..(!) I'L>
LOCATION
& PROJECT
INFO:
LOT #:
ft:,q
ADDRESS OF CONSTRUCTION:
/1..0 '0 WiAJi)~1l S
SEWER UTILITY WATER UTIlIT(-
PROVIDER: c: '1" n.. W b PROVIDER: c..A a 14 E L-
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA / BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNn WELL ANDIOR SEPTIC PERMIT #'S (IF APPUCABlE):
PHONE:
31'1 8' 8 (;"'-I9o
FAX:
31") ~7 ~ ~8'I{r.
STATE:
C! ,{-/t,..., C ~
ZIP:
SECTION:
I
ZONING:
SQUARE
FOOTAGE: '18'9 h
ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE) 5'" b 5'" (J 00 ,
.
For Single F .. ~'t9.... o/:t~~. ig}~.. S'\ ooels, and/or accessory structures, this permit is valid only if construction commences within 180
days of the d or iSsU~. ~ Qf-~ g., d must be completed (Certificate of Occupancy issued) within 18 months of the issuance date. Class I
structure pennits are~O\"o ~trative Rules of the State of Indiana (See 675 lAC 12) regarding expiration time frames for beginning and
tl~\"!~i:' GF" ...,0\ completing construction.
I, the undersignec!.::'W"f.~any constru'\H~ln, reconstruction, enlargement, relocation, or alteration of a structure, or any change in the use of land or structures
requested by this~ih[ion wilkomply with, and conform to, all applicable laws of the State of Indiana, and the "Zoning Ordinance of Cannel Indiana ~ 1993" (Z~
289) and amendments, adopted under authOrity of I.c. 36~7 et seq, General Assembly of the State of Indiana, and all Acts amendatory thereto. I further certify that only
kitchen, bath, and floor drains are connected to the sanitary sewer. I further certify that the construction will not be used or occupied until a Certificate of
Occupanc as been issued by the -Department of Community Services, Cannel, Indiana.
o
Early Release
Permit:
Lot Split:
~)
J.. n (!..4w"u +,LI '1- It ~
TAX MAP PARCEL #:
PLUMBING CONTRACTOR:
L b M cCI-(JJ.iUIC!1 <-
Plumber's Indiana State License #:
PLC
"i?1C>t.. 'f.S'YO
Which plumbing codes will be applied to the construction:
o .,)"temational Residential Code w/Indiana Amendments
jLJ Uniform Plumbing Code wI Indiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area)
o CRAWLSPACE 0 POST & BEAM PIER
o SLAB ~BASEMENT (WALKOUT:_Y , N)
/ ;i{)~k {,
Date/'
OFFICE USE ONLY: ******************************~~******~***************,!U**Z?J!*****************
INSPECTION RED: Filing Fees. 'f /L, "'7,
B I ct ;11 :::,0 # Charged Re-
F t' F . ase nspe ions: .
pper 00 I er 00 \/" '"0 Reviews
Cert. of Occupancy: , C} -3. .)/
P.R.I.F.: / -) b/. dO Additional Fees
: /77 JfIr-. .
Reviewed/Ap Dept. of Community Services
S:PermIts/FormS/ILP RESIDENTIAL