HomeMy WebLinkAbout06120071 Application
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City of Carmel! Clay Township Permit #: Ob i200 7/
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER of
RECORD:
NAME
PHONE
~Lt(; - ~~ '0 (
FAX
S11-"tI~
PROPERTY
OWNER:
STREET ADDRESS
1\ 11.'L
BUILDER'S EMAIL ADDRESS
P.. I( t20el-tt.-/N
NAME I< IY'1
I'L
STA;'IJ
ZIP
'flPo:13
lOT #
'1-0
/IJ
I'L
W ooch-
LJ(G I ~
BEST METHOD OF CONTACT:
t3- '1(',~'O~1 oil ail/o-llt.
PHONE8'1" _ <(-<(YI FAX~ll~ q ,S"3
cm~
STATE
fA)
ZIP
'Co:5.3
LOCATION
&. PROJECT
INFO:
STREET ADDRESS
11 '1..'1...
SUBDIVISIO
BfU
SECTION
O~
ZONING: .
s-,
SEWER UTILITY
PROVIDER:
ADDRESS OF CONSTRUCTION _ n
S S 2. s" P f>rvJN W'OOCf
o
WATER UTlLrro
PROVIOER:
SQUARE
FOOTAGE: SObS
C-JIri2rm ~
ESTIMATED COST OF CONSTRUCTION:
(EXCLUOlNG LAND VALUEr ~ ~ ~ ~~~c~Lf:;2.0 ~"::)
_ \ II ::-:J /;~", :"_,"0 c
'I i'_~ ',' .'; " ." II '
88Jt. 6~tohAic'-~~' ...
III '.II
MENT: PLUMBING CONTRACTOR:DEC 1 9 2006
S~-l\I!iW:.~~l:i. rfEONSTPi 'h,EDS ~.c~
o iW<HlbW\ ~(9'Jth all r~ Indiana !1tate License'#:--
OffEn ~A '!lj COdes onlli\- J '0 11l ,. ,{)9 (:;7 '1
C/i'Q,,REMOO'E!! dvlUNITY . _.. : -1.....- ___u __
~ t:yt-'A~511~B)I!tl;IilIH<t ~.;: ~~@"8'bi.ng codes will be applied to the construction:
o DETACHOO~~Gf' j v\J1l'\i8I/<\In8tional Residential Code wI Indiana Amend'i'ents
DO ATTEMAOCUTJHEDON ~ t8( Uniform Plumbing Code wI Indiana Amendments
D (Multi-Family Construction Code)
NAME OF UTIllTY 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:
00 SINGLE FAMILY
b TOWN HOME
o TWO FAMILY
# of units:
o MULTI,FAMILY
# of Units:
o RESIDENTIAL (For
Additions, Remodels, Etc.)
I,.
. '.
" Ii;
fl' }II
..1'1
f.. I
--1'---'1
I
J
PROJECT INFORMATION:
Early Release / Manufactured /
Permit: _ Y ~!:Y Trusses: Y VN
v'.. -/"-- 0 CRAWLSPACE
Lot Split: _Y _N Sump Pump: --V:-y _N 0 SLAB
Does any part of the property lie within a special Flood designation area: _Y ~
FOUNDATION TYPE: (Check all that apply for the new
construction area)
o
~
POST & BEAM
BASEMENT . /
WALKOUT:_ y--.t::::N
For Single Family and Two Family dwellings. additions, remodels, and/or accessory structures, this permit 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. Class I structure permits are subject to the General Administrative Rules of the State of Indiana (See 675 lAC 12) 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 ,,\ill comply with, and to, all applicable la\v!'> of rhe State of Indiana, and the "Zoning Ordinance of Carmel
Indiana - 1993" (Z~289) and amendments, adopted und thority of I. ~7 et seq, General As!'>embly of the State of Indiana, and all Acts amendatory
thereto. I further certify that only kitchen, bath, an oor drains arc connect to the sanitary sewer. I further certify that the construction will not be
used oroceu ied until a Certificate 0[0 cup cyhas been issued by the D artm;;; or;;'iunil!;,;:J!j;~mcl.lndiana. I 2(rTJI ~
Signature of OWner or Authorized Agent Date
OFFICE USE ONLY: *********
*****~ ****************j{~*~*~*~****************
F. ng Fees: 0 S' U
,,::;21/ 5' d
$'3. :{'iJ
Base Inspections:
Cert. of Occupancy:
# Charged Re-
Reviews
INSPE
Cupper F~II
1d-6
~ 7 Adf}"dnal Fees
(Date)
Fee Received by: