HomeMy WebLinkAbout06120032 Application
City of Carmel/Clay Township Permit #: or; I.2ClO 3'02-
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
&. PROJECT
INFO:
NAME:
(0)..),:>,
~o
STREET ADDRESS:
'-'
~
,
FlOOD ZONE AREA DESIGNATlON(S)
FOR THIS PROPERTY:
BUILDER'S EMAlL ADDRESS:
\.) A G2
NAME:
\..::>. '"
0...",
.C
STREET ADDRESS:
'::)'(9\ -, O~1>..1d2.
LOT #:
ADDRESS OF CONSTRUcnON:
~e,G.,.(
/
TYPE OF CONSTRUCTION:
~ SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
IFf RESIDENTIAL (For
Additions. Remodels. Etc.)
Early Release
Permit:
PROJECT INFORMATION:
-y~
_y--.i:N
SEWER UTIliTY
PROVIDER:
TYPE OF IMPROVEMENT:
o NEW STRUCTURE
o ROOM ADDITION(S)
o PORCH ADDmON(S)
o D~C ODmON(S)
rs;{ RE DEL
_ Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATIACHED GARAGE
o DEMOLmON
Manufactured
Trusses:
Sump Pump:
y~
A_N
PHONE:
~n C}-
FAX:
CITY:
STATE:
\'..J .
4~:\
.....:>....:l
BESTMETHOQ Of CO&TfO' .
'~:E2LE/~~gr:U }oA.Jr'{ C{)N5TRUCT'ON
""'n_^".'_.'
,"IU::"",,",,,,,~ .'... "",.,'
PHONE: ~
.._,."'.....~..-
t,f q~..
_."_ FAX:,." .-f,.. ~~.
",-.,.-...jo.,,-,......,"
. :~-.:..-~'':.n~.~'~{:t
STATE:
\W.
\' .;-(~I~~';.,,~~~~.r~P
",,,,.'
SEcnON:
ZONING:
SQUARE
FOOTAGE: \looo cJ
ESTIMATED COST OF CONSTRUfON:
(EXCLUDING LAND VALUE) -..., } {)
"'-''--0.000 _ D
NAME OF LfTlLfTY EXCAVATION CONTRACTOR; PLAN COMMISSION I BZA I BPW DOCKET
NUMBERS; TAC DATE(S); ANDIOR COUNTY WELL ANDIOR SEPTIC PERMIT #'S (IF APPLICABLE):
Lot Split:
TAX MAP PARCEL #:
n~~
ULt..
'inn'"
{(..IUD
PLUMBING CONTRACTOR:
~\e:b"V\...~h 1'A....i>-,j
Plumber's Indiana State License #:
~0_ eBe,bDd-~~
Which plumbing codes will be applied to the construction:
o j.ntemational Residential Code w/Indiana Amendments
0' Uniform Plumbing Code w/Indiana Amendments
FOUNDATION TYPE: (Check all that applv for the new
construction area)
o CRAWLSPA5f/ 0 POST & BEAM _~R
o SLAB ~ BASEMENT (WALKOLIT:_y~N )
For Single Family and Two Family dwellings, additions, remodels, and/or accessory structures, this permit is valid only if construction commences within ISO
days of the date of issuance of the building pennit, 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 will comply with, and confonn to, all applicable laws of the State of Indiana, and the "Zoning Ordinance of Cannel Indiana - 1993" (Z-
289) a d amendments, adopted under authority of LC. 36-7 et seq, General Assembly of the State of Indiana, and all Acts amendatory thereto. I further certify that only
kitche 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
Occu cyhas been issued by ~1e~ Community Services. Carmel, Indiana.
\, v>---'\~ . \~~~ \. v'8t.-e.V\\.<; 1"d-B-01-
Signature of Owner or A ed Ag~nt Print Date
***********************************************************************
F'r' F / J"3 SO
INSPECTIONS REQUIRED: ling ees: ';1/. '<70
Base Inspections:
Upper Footing Lower Footing Under Slab
c;: Cert.ofOccupancy: ':;-1
Rough In ") Meter Base C Final ~
_ ~ P.R.I.F,:
OFFICE USE ON
Fee Recelv
# Charged Re.
Reviews
5"0
Additional Fees
Date