HomeMy WebLinkAbout06110127 Application
City of Carmel! Clay Township Permit #: t1 (, II fJ I ~ t"
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, & Two Family: New Structures, Additions, Remodels, & Accessory Structures
STREET ADDRESS:
,2 ~l..
FAX:
"17-53;2
BUILDER
OF
RECORD:
NAME:
t.... .....-.
y'^,rO;)M.~ Or j.""J,,<\,,,
.,~:
ZIP:
()<)
BUILDER'S EMAIL ADDRESS:
r
PROPERTY
OWNER:
NAME: To>'>'\. -R G.~ Le
STREET A DRESS:
17/ 6('o6}t.,:>
PHONE:
S
.c;7/-llg..;-
LOCATION
& PROJECT
INFO:
cm: STATE: ZIP:
C"V.""" "\ ;;l..
SECTlON: / ZONING:
.r- L/isJ() 3~ SQUARE
,J... FOOTAGE:
ESTIMATED COST OF CONSTRUcnON: 5'00. ,,~.
(EXCLUOING LAND VALUE)
SEWER UTIliTY
PROVIDER:
lot Split:
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION / BZA ;"BfW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUN1Y WELL AND/OR SEPTIC PERMIT/.'S (IFAPPUCABLE):
I:I!I,--r::::::-'t;-~~.
II!.,?I -"-'~gf!.//'\l>,:~.o::M,~PPARCEL#:. . J
III ill -.('//.5;."''':. .-/ -07-0)..-(;)..., Oi$.ooo
I 'II II '0 ...................... Ii,; j
TYP~ OF IMPROVE~ENT: 'JI 2 PlUMBING";€ONTRACTOR:
/U~E" B 2l2' ,I ! i
PORCH (S~);'~ iiIUililier'i'~ d' 7/a State license #:
o DECK ADDmDN(S) '- ~J t.!: !
~REMODEr--) F' . h I Wl:1!ch prumb1o'n / codes will be applied to the construction:
Bp,&(.n,e.nt InIS on y .., ~ '
o ACCESSORY BUILDING 0 Int~ onal Residenti.a~t\N/Indiana Amendments
o DETACHED GARAGE . "ra,\.\v ~ .,,rlJ
o ATTACHED GARAGE 0 Unofonn I!I"""'lbg Co,!~,,~iriidrana Amendments
;"'l~ GCJ1'''''' \' 8.~~.~
o DEMOlITION o..~\ " ",,. "'.
,.. il$f'~ul!NPA.T'I0'~'!yf5IV~~.~~~~~t~lhat apply for the new
fl...'E.\...~ ol.""I- :(,eoWstrl.:'~~on are~)...! ~~\~~,---:, ~~ _'""e',' :1-'~\?
~€'!c\ ..~,. """,.~,--.",, ' 0:,',. "';'.;,.<~.":,,j';':>\.
_Y --...s(lb," (); '0'" '.~/O 'CRAWLSP(I<;E"\,CCi' 'POST & _ BEAM _PIER
, ,,~r:, (_,<...i" " ;:7"},M"
_Y LN n<::I'~' ,.," :~:,~SLA~~~.~0 BASEMENT (WALKOUT:_Y_N )
v"l.-",," r.J.\{-.- _..<,~..:,i:;..""~
...- ~''i.
For Single Family:md Two Family dwellings, additions, remodels, and/or~.ls structures, thislPennit is valid only if construction commences within 180
days of the date of issuance of the building permit, and must be completed (Certificate of Occupancy issued) 'within 18 months of the issuance date. Clas~ I
structure permits are subject to the General Administrative Rules of the State of Indiana (See 675 lAC ll) regarding expiration time frames for beginning and
completing construction.
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alteration of a structure, or any change in the use of land or structures
requested by this application will comply wit conform to, a . cable laws of the State of Indiana, and the "Zoning Ordinance of Carmel Indiana - 1993~ (Z-
289) and amendments, adopted under a oriry of LC. 36-7 et seq, Generar-As~:mbly of the State of Indiana, and all Acts amendatory thereto. I further certify that only
kitchen, bath, floor drains are c nected to the sanitary sewer. I further ce'rtitY that the construction will not be used or occupied until a Certificate of
Occupan en issued eDepartmentoICOmmUnity~c ,In:~~) ;gfee-/- /1-..< 7-d(/:;>
gnature ... prin Date
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY:
TYPE OF CONSTRUCTION:
V SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
~ ./ time:
[\?" RESIDENTIAL (For
Additions. Remodels. Etc.l
PROJECT INFORMATION:
Early Release
Permit:
Y N
Y X"N
Manufactured
Trusses:
Sump Pump:
INSPECTIONS REQUIRED:
Upper Footing Lower Footing Under Slab
~ MeterBas~ Site
***********************************~*J*******************
Filing Fees: /"?J 3. ,)
/ / I {lO
,<;' 3, s{)
Base Inspections:
Cert. of Occupancy:
# Charged Re-
Reviews
P.R.I.F.:
,
/
Additional Fees
;t';2f? 00
;'. -I L //)
--(,?'i/
/ TOTAL:.
~t!{>{~)
Fee Received by:
.'
Date