HomeMy WebLinkAbout06120077 Application
City of Carmel/Clay Township Permit #:001:2 oD77
'-'RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER of
RECORD:
;.s
STREET ADORES';; ::> _
t.tP3.-:> 0
NAME
FAX
75/5 59 -75<fo
STATE . ZIP. -../
<LA! .(j ~,25:)
- /03 7
PROPERTY
OWNER:
NAME
tY:r
FAX
STREET ADDRESS
CITY
STATE ZIP
ZONING: vb
SQUARE Sl'lD~
FOOTAGE:
LOCATION
&. PROJECT
INFO:
LOT #
23:2
SEWER UTILITY EST1MATED COST OF CONSTRU'l19N:
PROVIDER: CTew 6' (EXClUDING LAND VALUE) dt> /50 tJa:>-
NAME OF UTILITY EXCAVATION CONTRACTOR;:PlAN COMMISSION I BZA I BPW DOCKET 0 I D 7 .
NUMBERS; TAC DATE(S);~~~;~~rf~~'fN~(?R SEPTIC PERMIT #'S (IF APPUCABLE): L tJ n,a. r .5 fr J cJ7~~
~~. ...,.' '\ ~ \1\ \~\
TYPE OF.~.ONs.:rRlI.~ON:':'--~ TY;PlE RF IMPROVEMENT: PLUMBING CONTRACTOR:
'ItJ SIN..G~fFl\MICY It;'J:Jo \;r ~EW STRUCTURE '- J. K. Su ,M J;, 0 '
t:'l TOWr-j lH,OME t" t ~ .: R?OM ADDmON(S) Plumber's Indiana State License #:
o TWP,~M.ILY~t.\' ______ PQRCH ADDmON(S) / '1"'-/ {I (; Ie;) P
# 9f\u~l1f: ...------ 0 REMODEL - I
o MULTI\F~MILY ~ ~ ACCESSORY BUILDING
# Of\Units~-- ____ 0 DETACHED GARAGE
o RESIDENTIAL (F.or-- 0 ATTACHED GARAGE
AdditiohsrRemodels, Etc.) 0 DEMOLmON
Which plumbing codes will be applied to the construction:
o International Residential Code wfIndiana Amendments
o Uniform Plumbing Code wfIndiana Amendments
(Multi-Family Construction Code)
PROJECT INFORMATION:
Early Release Manufactured FOUNDATION TYPE: (Check all that apply for the new
Permit: _Y 1..N Trusses: _Y -YN construction area)
I- 0 CRAWLSPACE 0 POST & BEAM
Lot Split: _Y':b-N Sump Pump: " Y _N 0 SLAB ~ BASEMENT
Does any part of the property lie within as." 1II1ood designation area: _Y 1..N WALKOUT:_y.jC..N
For Single Fa~y and ~ ~ " . ~els, and/or accessory structures, this permit is valid only if construction commences
within 18m~\I~~!l~~6N't\ po . ng permit, and must be completed (Certificate of Occupanciissued) within 18 months oftbe
issuance da~~\&b\ \~r~~not~tG ~":'tlY\j5idministrative Rules of the State of Indiana (See 675 lAC 12) regarding expiration
Su \ 1 Sta.te an ...\\rt~ 0 . ning and completing construction.
I, the undersigned. agre~jlJ.at~~~; ~~~tl4 ement, relocation, or alteration of a structure, or any change in the use of land or
structures re. ttJfaI:~~~~Y Wiht', and conform to, all applicable laws of the State of Indiana, and the "Zoning Ordinance of Carmel
Indiana -1993" ~ s~~~~~, aQ,CiI'\~ und,er authority of I.c. 36,7 et seq, General Assembly of the State of Indiana, and all Acts amendatory
thereto. I fur tifflliat only ki\~~tMlt,.and'floordrains are connected to the sanitary sewer. I further certify that the construction will not be
used or occupie until a Certifica.te of Occupancy has bee~sued by the Depar ment of Community Services, Carmel, Indiana.
:'. I, . / /" "
~l' " Ll)
Signature of Owner or Authorized Agent ( I Pri t
/.2-;:2O-Db
Date
OFFICE USE ONLY: ********~*****
INSPECTl EQUIRED:
~- ow~r Footing Under Slab
E3.e,....~0
-Db
(Date)
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Filing Fees:
Base Inspections:
Cert. of Occupancy:
# Charged Re-
Reviews
P,R.LF,,: J /] (II (/ () . Additional Fees
,'U~ lj~/f:]'I'b(J
Fee Received by: